Utilization of Gynaecological Drugs Among Privately Insured Women Aged 12 Years and Older in Germany: A Trend Analysis of Claims Data

Background: Menstrual and menopausal complaints are highly prevalent among women in Germany. Pharmacological options include hormonal contraceptives, menopausal hormone therapy and herbal medicinal products (HMPs). However, real-world data on the prescription of HMPs in comparison with hormone preparations are scarce. Objective: To describe trends in the number and proportion of packages of hormone preparations and HMPs within ATC groups with pharmacotherapeutic relevance to menstrual and menopausal complaints, using claims data from German private health insurance (PHI). As no diagnoses were available, the study does not address the indications for which the products were prescribed. Design: Repeated cross-sectional observational study. Methods: Claims data were derived from the drug project of the Scientific Institute of Private Health Insurance (WIP), including all packages dispensed to women aged ≥12 years from 2019 to 2022 within the ATC groups G03A, G03C, G03F or G02CP. In total, 2.8 million drug packages were analysed using descriptive methods and exploratory quasi-binomial regression models. Key Results: Hormone preparations (G03) accounted for 91.5% of all packages, compared with 8.5% for gynaecological HMPs (G02). Following an initial decline until 2021, the number of hormone packages nearly returned to the level in 2019, whereas the number of HMP packages showed a continuous downward trend. Among menstruation-related preparations dispensed to younger women (aged 12–25 years), hormonal contraceptives (G03A) accounted for the vast majority (92.2%). The proportion of HMP packages (G02CP01, -02, -05, -07, -08) increased steadily with age, exceeding the proportion of G03A packages among women aged over 60 years (59.2% vs. 40.8%). Among menopause-related preparations, hormone packages (G03C, G03F) predominated across all age groups (>90%) and HMP packages (G02CP03, -04, -53) accounted for less than 10%. Conclusions: Among privately insured women in Germany, hormone preparations accounted for most packages in both medication groups, whereas HMPs accounted for a small and declining share that increased with age only in the menstruation-related group. PHI claims data can complement statutory health insurance data, as they also capture prescribed non-prescription drugs such as HMPs.