Temporal trends in the prescription of low-dose antithrombotic and anti-inflammatory therapies in Germany (2022–2024)

Aims This study aimed to investigate the prescription rates of low-dose antithrombotic and anti-inflammatory therapies in Germany from 2022 to 2024. Methods We analyzed national outpatient claims data from the German Institute for Drug Use Evaluation. Claims data for patients receiving the following medications were included: aspirin 100 mg, clopidogrel 75 mg, prasugrel 5 mg and 10 mg, ticagrelor 60 mg and 90 mg, rivaroxaban 2.5 mg, and colchicine 0.5 mg. Drug utilization was quantified using defined daily doses per 1000 Statutory Health-insured persons per day (DID, 10 DID = approximately 1% of the population receive the drug daily). Results In 2024, aspirin had the highest dispensing volume (47.4 DID), followed by clopidogrel (10.6 DID). All other substances were infrequently prescribed: prasugrel 5 mg (0.065 DID) and 10 mg (1.388 DID), ticagrelor 60 mg (0.103 DID) and 90 mg (0.978 DID), rivaroxaban 2.5 mg (1.535 DID), and colchicine (0.457 DID). Rivaroxaban 2.5 mg was the only drug showing a notable increase in utilization over time (+ 42% from 2022 to 2024). Cardiologists accounted for a small proportion of prescriptions (mean DID share 3.3%, 1.8% of all dispensed DDD). Aspirin use increased consistently with age, while rivaroxaban 2.5 mg peaked in the 70–74 age group. In contrast, ticagrelor 60 mg was more frequently prescribed in middle-aged patients. Conclusion Despite the high prevalence of coronary artery disease (CAD), the use of long-term antithrombotic and anti-inflammatory therapies for secondary prevention in patients with CAD remains low in Germany, especially among older patients. Graphical abstract Temporal trends in the prescription of low dose antithrombotic and anti-inflammatory therapies in Germany (2022–2024). ASA = aspirin, CAD = coronary artery disease, DAPI = German Institute for Drug Use Evaluation (Deutsches Arzneiprüfungsinstitut e.V.), DDD = Defined Daily Dose, DID = Defined Daily Dose per 1000 inhabitants per day, ESC = European society of cardiology, SHI = statutory health insurance