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Publication
Sales of anti-smoking drugs in Portugal (2010-2020)
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Abstract(s)
O consumo de tabaco representa anualmente em todo o mundo 8 milhões de mortes prematuras, com 1,2 milhões causadas pelo fumo passivo. A dependência de nicotina é um importante contribuinte para a utilização contínua destes produtos, que podem causar doenças como o cancro e DPOC, entre outras. Foram introduzidas farmacoterapias como terapias de substituição de nicotina (TSN), vareniclina, bupropion e outras intervenções não farmacológicas para ajudar os fumadores a deixarem de fumar.
Esta dissertação analisa as vendas de nicotina, vareniclina e bupropion em Portugal de 2010 a 2020. Além disso, foram analisados os seus mecanismos, farmacocinética, efeitos adversos, eficácia e dosagens. Os dados foram fornecidos pelo Centro de Informação do Medicamento e Produtos de Saúde e a revisão narrativa foi feita usando as bases de dados PubMed, Science Direct e Google académico incluindo referencias a partir de 2004 com enfase nos últimos 10 anos.
Os resultados mostraram que as TSN são a farmacoterapia preferida, representando 70,47% das vendas totais para a cessação tabágica. O ano de 2012 foi o pico em termos de vendas, com 124 834 unidades vendidas. A vareniclina foi a segunda escolha para a cessação tabágica, representando 29,10% das vendas totais. Foi detetado um aumento de 48,3% nas vendas de 2016 para 2017 devido ao reembolso, disponibilizado pelo sistema nacional de saúde, que entrou em vigor em 2017. Por outro lado, o bupropion, demonstrou uma contribuição residual, representando apenas 0,43% das vendas.
Em termos de eficácia, os três medicamentos mostraram resultados positivos, com a vareniclina sendo a terapia única mais eficaz, seguido das TSN e bupropion que apresentaram resultados semelhantes. No entanto, a combinação de intervenções provou ser mais bem-sucedida na obtenção de uma cessação tabágica prolongada, reduzindo as chances de recidiva por parte dos pacientes e abandonarem o tratamento. Alguns efeitos adversos comuns associados a estes medicamentos são insónias, náuseas, dores de cabeça, tonturas, diarreia e obstipação. A vareniclina e bupropion apresentaram efeitos adversos mais graves, embora raros, como depressão, ideação suicida, efeitos cardiovasculares e outros efeitos psiquiátricos.
Em conclusão, o consumo de produtos de tabaco continua a ser um problema importante para a saúde pública, mas os dados mostram que mais pessoas procuram tratamentos para ajudá-las a deixar de fumar.
Tobacco usage worldwide represents annually 8 million premature deaths with 1,2 million being caused by second-hand smoke. Nicotine addiction is a major contributor to the continuous use of these tobacco products that can cause diseases like cancer, chronic obstructive pulmonary disease among others. Pharmacotherapies like nicotine replacement therapies (NRT), varenicline, bupropion and other nonpharmacological interventions were introduced to help smokers quitting. This dissertation aimed to analyze the sales of nicotine, varenicline and bupropion in Portugal from 2010-2020, and to review their mechanisms, pharmacokinetics, adverse effects, efficacy, and dosages were analyzed. The sales data was provided by Centro de Informação do Medicamento e Produtos de Saúde (CIMI) and the literature review was conducted using Pubmed, Science Direct and Google Sholar as databases and references were included form 2004 onwards, focusing in the last ten years. Results showed that NRT is the preferred pharmacotherapy representing 70.47% of total smoking cessation sales. The year of 2012 was the peak in terms of sales with 124 834 units sold. Varenicline was the second choice for smoking cessation representing 29,10% of total sales. A 48,3% increase in sales was detected from 2016 to 2017 due to the reimbursement provided by the national health care system which started in 2017. Bupropion on the other hand demonstrated a residual contribution with only 0,43% in terms of sales. In terms of efficacy, all 3 drugs showed positive results, with varenicline being the most effective single therapy and NRT and bupropion showing similar results. However, the combination of interventions proved to be more successful in achieving prolonged smoking cessation, reducing the chances of patients resuming smoking and quitting the treatment. Some common adverse effects associated with these medications are insomnia, nausea, headaches, dizziness, diarrhea, and constipation. Varenicline and bupropion also presented more severe adverse effects although rarer like depression, suicidal ideation, cardiovascular effects, and other psychiatric effects. In conclusion, consumption of tobacco products remains a major public health issue, but the data showed that people are seeking for treatments to help them quit consuming.
Tobacco usage worldwide represents annually 8 million premature deaths with 1,2 million being caused by second-hand smoke. Nicotine addiction is a major contributor to the continuous use of these tobacco products that can cause diseases like cancer, chronic obstructive pulmonary disease among others. Pharmacotherapies like nicotine replacement therapies (NRT), varenicline, bupropion and other nonpharmacological interventions were introduced to help smokers quitting. This dissertation aimed to analyze the sales of nicotine, varenicline and bupropion in Portugal from 2010-2020, and to review their mechanisms, pharmacokinetics, adverse effects, efficacy, and dosages were analyzed. The sales data was provided by Centro de Informação do Medicamento e Produtos de Saúde (CIMI) and the literature review was conducted using Pubmed, Science Direct and Google Sholar as databases and references were included form 2004 onwards, focusing in the last ten years. Results showed that NRT is the preferred pharmacotherapy representing 70.47% of total smoking cessation sales. The year of 2012 was the peak in terms of sales with 124 834 units sold. Varenicline was the second choice for smoking cessation representing 29,10% of total sales. A 48,3% increase in sales was detected from 2016 to 2017 due to the reimbursement provided by the national health care system which started in 2017. Bupropion on the other hand demonstrated a residual contribution with only 0,43% in terms of sales. In terms of efficacy, all 3 drugs showed positive results, with varenicline being the most effective single therapy and NRT and bupropion showing similar results. However, the combination of interventions proved to be more successful in achieving prolonged smoking cessation, reducing the chances of patients resuming smoking and quitting the treatment. Some common adverse effects associated with these medications are insomnia, nausea, headaches, dizziness, diarrhea, and constipation. Varenicline and bupropion also presented more severe adverse effects although rarer like depression, suicidal ideation, cardiovascular effects, and other psychiatric effects. In conclusion, consumption of tobacco products remains a major public health issue, but the data showed that people are seeking for treatments to help them quit consuming.
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Keywords
Cessação tabágica Terapia de substituição de nicotina Vareniclina Bupropion Smoking cessation Nicotine replacement therapy Varenicline