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Table 2 Costs of surrogates for the elderly (Prices in €, Reference year 2009)

From: Potentially inappropriate medication in the elderly in Germany: an economic appraisal of the PRISCUS list

ATC-Code Agent Costs per DDD in € DDD (in Mio.) Surrogates according to PRISCUS list Costs per DDD of surrogates in € Total costs of surrogates in Mio. €
      Min   Max   Mean Min Max Mean
C02CA04 Doxazosin 0.38 51.4 Other antihypertensives: ACE inhibitors, angiotensin receptor blockers, diuretics, beta blocker, calcium channel blocker ACE inhibitors 0.13 Angiotensin receptor blockers 1.08 0.23 6.64 55.51 23.73
N06AA09 Amitriptyline 0.43 45.7 SSRIs, mirtazapine SSRIs 0.49 Mirtazapine 0.69 0.53 22.39 31.53 23.32
C07AA07 Sotalol 0.30 34.0 Beta blocker, amiodarone, propafenone beta blocker 0.30 Amiodarone 0.72 0.77 10.09 24.48 21.69
C01AA02 Acetyldigoxin 0.36 32.5 Beta blocker, diuretics, ACE inhibitors ACE inhibitors 0.13 Beta blocker 0.30 0.18 4.20 9.65 24.43
N05CF01 Zopiclona 0.77 28.0 Valerian, sedative anti-depressants (trazodone, mianserin, mirtazapine), opipramol, low-potency neuroleptics (melperone & pipamperone) Valerian 0.00 Low-potency neuroleptics 2.32 0.77 0.00 64.86 11.80
M01AH05 Etoricoxib 1.21 25.2 Paracetamol, weak opioids (codeine, tramadol), Metamizole, weak NSAID, antidepressants (long-acting tranquilizers, tricyclic antidepressants, other non-serotomergic monoamine oxidase inhibitors, SSRIs, other Selective reuptake inhibitors, other antidepressants), anticonvulsants (older anti-epileptics, newer anti-epileptics, neuromuscular blocking agents) Paracetamol 0.49 Newer anti-epileptics 4.03 3.90 12.35 101.56 16.50
N06AA12 Doxepin 0.54 24.2 SSRIs, mirtazapine SSRIs 0.49 Mirtazapine 0.69 0.53 11.86 16.70 12.94
G04BD08 Solifenacin 1.44 22.6 Trospium Trospium 1.05 Trospium 1.05 1.05 23.73 23.73 5.89
N05CF02 Zolpidema 0.77 21.3 Valerian, sedative anti-depressants (trazodone, mianserin, mirtazapine), opipramol, low-potency neuroleptics (melperone & pipamperone) Valerian 0.00 Low-potency neuroleptics 2.32 0.77 0.00 49.34 2.95
N06BX03 Piracetam 0.45 18.3 ACE inhibitors (donepezil, galantamine, rivastigmine), Memantine Memantine 3.86 Acetylcholinesterase inhibitors 4.25 4.11 70.64 77.78 7.80
C04AD03 Pentoxifylline 0.48 15.0 ACE inhibitors (donepezil, galantamine, rivastigmine), Memantine Memantine 3.86 Acetylcholinesterase inhibitors 4.25 4.11 57.90 63.75 10.36
N05BA08 Bromazepam 0.58 14.9 Lorazepam, lormetazepam, short-acting benzodiazepine & benzodiazepine receptor agonists (zolpidem, zopiclone, brotizolam, triazolam, zaleplon), opipramol, mirtazapine, low-potency neuroleptics (melperone & pipamperone) Lormetazepam 0.42 Low-potency neuroleptics 2.32 0.75 6.26 34.52 9.77
N06AA06 Trimipramine 0.74 14.6 SSRIs, mirtazapine SSRI 0.49 Mirtazapine 0.69 00.53 7.15 10.07 11.23
N05BA01 Diazepam 0.46 13.1 Lorazepam, lormetazepam, short-acting benzodiazepine & benzodiazepine receptor agonists (zolpidem, zopiclone, brotizolam, triazolam, zaleplon), opipramol, mirtazapine, low-potency neuroleptics (melperone & pipamperone) Lormetazepam 0.42 Low-potency neuroleptics 2.32 0.75 5.50 30.35 75.19
N05CD06 Lormetazepama 0.42 12.5 Valerian, sedative anti-depressants (trazodone, mianserin, mirtazapine), opipramol, zolpidem, low-potency neuroleptics (melperone & pipamperone) Valerian 0.00 Low-potency neuroleptics 2.32 0.78 0.00 28.96 30.82
C02CA08 Terazosin 0.54 12.3 Other antihypertensives: ACE inhibitors angiotensin receptor blockers, diuretics, beta blocker , calcium channel blocker (except nifedipine) ACE inhibitors 0.13 Beta blocker 0.30 0.18 1.59 3.65 6.79
C02AC01 Clonidine 0.50 11.7 Other antihypertensives: ACE inhibitors, angiotensin receptor blockers, diuretics, beta blocker , calcium channel blocker ACE inhibitors 0.13 Angiotensin receptor blockers 1.08 0.23 1.51 12.64 61.64
C02LA01 Reserpine and Diuretics 0.42 11.3 Other antihypertensives: ACE inhibitors, angiotensin receptor blockers, diuretics, beta blocker, calcium channel blocker (except nifedipine) ACE inhibitors 0.13 Beta blocker 0.30 0.18 1.46 3.35 2.24
C01BC04 Flecainide 1.18 9.7 Beta blocker, amiodarone Beta blocker 0.30 Amiodarone 0.72 0.30 2.88 6.98 9.87
G04BD04 Oxybutynin 0.95 9.3 Trospium Trospium 1.05 Trospium 1.05 1.05 9.77 9.77 2.69
M01AC06 Meloxicam 0.35 9.3 Paracetamol, weak opioids (codeine, tramadol), metamizole, “weaker” NSAID Paracetamol 0.49 Codeine 2.65 0.72 4.56 24.65 9.69
N06AB03 Fluoxetine 0.33 8.8 Other SSRIs (citalopram, paroxetine, escitalopram, sertraline, escitalopram), trazodone, mitrazapine other SSRIs 0.51 Trazodone 1.44 0.56 4.50 12.67 8.71
M01AB01 Indometacin 0.46 8.7 Paracetamol, weak opioids (codeine, tramadol), metamizole, “weaker” NSAID Paracetamol 0.49 Codeine 2.65 0.72 4.26 23.06 4.60
C01AA08 Metildigoxin 0.32 8.4 Beta blocker, diuretics Diuretics 0.21 Beta blocker 0.30 0.26 1.76 2.49 2.06
M03BX07 Tetrazepam 0.96 8.3 Tolperisone, short-acting benzodiazepine & benzodiazepine receptor agonists (zolpidem, zopiclone, brotizolam, triazolam, zaleplon), intermediate-acting tranquilizers (bromazepan, oxazepam, lorazepam, alprazolam, buspirone) intermediate-acting Tranquilizers 0.71 Tolperisone 1.55 0.82 5.89 12.87 12.59
C04AX21 Naftidrofuryl 1.09 7.5 ACE inhibitors (donepezil, galantamine, rivastigmine), memantine Memantine 3.86 Acetylcholinesterase inhibitors 4.25 4.11 28.95 31.88 6.25
C08CA05 Nifedipinea 0.58 6.5 Other antihypertensives: ACE inhibitors, angiotensin receptor blockers, diuretics, beta blocker, calcium channel blocker (except nifedipine) ACE inhibitors 0.13 Beta blocker 0.30 0.18 0.84 1.93 1.19
M01AB11 Acemetacin 0.77 6.4 Paracetamol, weak opioids (codeine, tramadol), metamizole, “weaker” NSAID Paracetamol 0.49 Codeine 2.65 0.72 3.14 16.96 6.68
M03BX01 Baclofen 0.87 6.0 Tolperisone, tizanidine Tizanidine 1.09 Tolperisone 1.55 1.45 6.54 9.30 4.91
J01XE01 Nitrofurantoin 0.76 5.4 Other antibiotics in accordance with antibiogramm: cephalosporins, cotrimoxazole, trimethoprim Cotrimoxazole 1.77 Trimethoprim 2.79 2.33 9.56 15.07 2.16
Sum Top 30   502.9        325.93 810.03 430.46
  1. aPRISCUS agents which are potentially inappropriate at certain dose or release form