# Temporal Trend in Selective Cyclooxygenase‐2 Inhibitors Sales in Brazilian Drugstores

## TL;DR

This study analyzed the sales trends of selective COX-2 inhibitors in Brazil from 2014 to 2021, finding an overall increase in consumption.

## Contribution

The study provides new insights into regional and national sales trends of coxibs in Brazil over a seven-year period.

## Key findings

- Celecoxib and etoricoxib sales increased in Brazil from 2014 to 2021.
- Celecoxib was the most used coxib, with the highest increase in the South region.
- Etoricoxib sales increased in the Midwest region but decreased nationally after 2018.

## Abstract

To assess the trends in selective cyclooxygenase‐2 inhibitor anti‐inflammatory drugs (coxibs) sales in Brazil from 2014 to 2021.

A time trend analysis of coxibs sales in Brazil from January 2014 to December 2021 was conducted using the Brazilian National Controlled Products Management System. Primary outcomes consisted of coxibs sales in defined daily dose (DDD) and DDD per 1000 inhabitants per day (DID), analyzed by Brazilian region (North, Northeast, South, Southeast, and Midwest). The trends in coxib consumption were analyzed using a segmented regression model, and the average annual percent change (AAPC) with a 95% confidence interval (95% CI) was calculated.

Celecoxib and etoricoxib sales increased in Brazil from 2014 to 2021. Celecoxib sales rose from 0.2 to 0.4 DID (AAPC 15.0; 95% CI 8.9, 21.5), particularly in the South, from 0.4 in 2014 to 0.7 DID in 2021 (AAPC 11.8; 95% CI 6.9, 16.9). Etoricoxib sales increased from 0.1 to 0.2, especially in the Midwest (AAPC 10.6; 95% CI 5.5, 16.0). Northern Brazil presented the lowest coxibs' consumption, which also increased in the period. National changes in etoricoxib sales were observed between 2014 and 2018 (annual percent change, APC 12.2; 95% CI −2.0, 28.4) and 2018 and 2021 (APC −3.6; 95% CI −22.1, 19.3).

Coxibs sales in Brazil increased from 2014 to 2021, and celecoxib was the most used coxib. Shift changes in sales were observed in some regions for both coxibs, and nationally for etoricoxib. Prescription retention requirements for coxibs sales, instituted a decade before this analysis, potentially did not reduce consumption.