Background

Over-the-counter (OTC) drugs are widely used by adolescents. This study investigated how much is spent on OTC drugs and for what kind of OTC drugs adolescents spend the money.

Methods

Data on drug use (past 4 weeks) were collected for 4,677 adolescents from two German birth cohorts (GINIplus/LISAplus) with a self-administered questionnaire. The drugs were grouped into OTC drugs and prescription drugs and were classified according to the anatomical therapeutic chemical classification (ATC) system. Drug prices were tracked via the pharmaceutical identification number or conservatively estimated.

Results

Overall, 41.1% of the 4,677 adolescents used a total of 3,873 drugs within 4 weeks. 70% were OTC drugs. The mean price for an OTC drug was 8.33 EUR (range: 0.94–158.98 EUR). 80% cost less than 10 EUR. The use of OTC drugs costing 10 EUR or more correlated with higher socioeconomic status. The prices of all OTC drugs used within 4 weeks summed up to 22,111 EUR (27% of the prices’ sum for all drugs used), corresponding to 5 EUR per adolescent (n = 4,677) or 15 EUR per OTC drug user (n = 1,486). The biggest share of this sum is caused by the ATC groups R05 (cough and cold remedies; 16.2%), M01 (antiinflammatories; 11.4%), R01 (nasal preparations; 9.4%), R06 (antihistamines; 5.3%), A03 (drugs for gastrointestinal disorders; 4.7%), R02 (throat preparations; 4.7%) and N02 (analgesics; 4.3%). The most mentioned active ingredient (ibuprofen; M01AE01) accounted for 8.4% of the expenditures for OTC drugs.

Conclusions

In Germany, OTC drugs (70% of all drugs used by adolescents) are covered by statutory health insurance up to the age of 12 years only. Full coverage for all age groups is currently being discussed, which would entail higher costs for the statutory health care system. However, also the potential of OTC drugs to save money should be taken into account, e.g. if used in time as ’early intervention’, OTC drugs may prevent sick leave or cost-intensive treatment.

Key messages:

• The use of (higher priced) over-the-counter drugs, which account for a substantial percentage of all drugs used by adolescents, is associated with a higher socioeconomic status.
• The costs for reimbursement of specific over-the-counter drugs also for those older than 12 years could be manageable and might be well invested money for the health care systems.