Patterns of prescription dispensation and over-the-counter medication sales in Sweden during the COVID-19 pandemic

Pär Karlsson; Aya Olivia Nakitanda; Lukas Löfling; Carolyn E. Cesta

doi:10.1371/journal.pone.0253944

Peer Review History

Original SubmissionFebruary 27, 2021
20 May 2021 Decision Letter - Sherief Ghozy, Editor PONE-D-21-06619 Patterns of prescription dispensation and over-the-counter medication sales in Sweden during the COVID-19 pandemic PLOS ONE Dear Dr. Cesta, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. Please submit your revised manuscript by Jul 04 2021 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. 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(Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: The study is relevant and well conducted. Here are just some minor comments that might slightly improve this well-written manuscript. The introduction is very brief. It would be useful to the reader if eg. more details of the preventive actions taken by Läkemedelsverket were given. 107 Consider replacing the word “interventions” with “products” or similar. 266 Individuals normally don’t dispense themselves, they tend to have their medication dispensed. 355 Please include the reference. Reviewer #2: 1-List abbreviation after full words such as (SARS-CoV-2) 2-No ethical approval was obtained? 3-In discussion section, please add a paragraph about the increase of OTC medication due to the fear of shortage of drugs due to lockdown, people buy a large amount of OTC medication at one time for sticking to the predicted lockdown which occurred in the last of March 2020,....etc 4-Was there an overwhelmed hospitals and clinics during this surge of OTC medication? Because it can be another explanation to that surge as people will try to treat symptoms at home. ****** 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review?** For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: No Reviewer #2: No [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0253944.r001
Revision 1
10 Jun 2021 Author Response PONE-D-21-06619 Patterns of prescription dispensation and over-the-counter medication sales in Sweden during the COVID-19 pandemic PLOS ONE Dear PLOS ONE Academic Editor Sherief Ghozy and reviewers, Thank you for your thoughtful review of our manuscript and for the opportunity to submit a revised version for your consideration. Two copies of the manuscript are submitted, one a clean copy, the other with tracked changes. Any mention of page numbers in the point-by-point response refer to the clean version. Note that we have initiated some revisions because in the time since submitting the manuscript, we have acquired data for the remainder of 2020 (October to December). All figures and tables have been updated with the additional data. The methods, results and discussion has been updated accordingly. The notable new results include a lower than predicted volume of dispensations of ATC group J until the end of the year, and substantial decrease in OTC drugs in ATC group B at the end of 2020, otherwise the main findings presented in the first submission remain the same. Sincerely, Carolyn Cesta Author’s response to reviewer comments (in blue) Reviewer #1: The study is relevant and well conducted. Here are just some minor comments that might slightly improve this well-written manuscript. The introduction is very brief. It would be useful to the reader if eg. more details of the preventive actions taken by Läkemedelsverket were given. We have moved from Discussion to the Introduction section (lines 92-96) details about prescription filling in Sweden and the restrictions on them by Läkemedelsverket. 107 Consider replacing the word “interventions” with “products” or similar. As recommended, “interventions” has been changed to “products” 266 Individuals normally don’t dispense themselves, they tend to have their medication dispensed. The sentence has been rephrased to “The contribution of new users versus stockpiling behavior to the increase in prescription dispensations will differ between diagnoses and medications”(line 267 in clean version) 355 Please include the reference. Since we now have complete data for all of 2020, these sentences have been removed from the limitations in the discussion. Reviewer #2: 1-List abbreviation after full words such as (SARS-CoV-2) The full name of SARS-CoV-2 and COVID-19 has now been added before their abbreviations when first mentioned in the abstract and the main text. 2-No ethical approval was obtained? Ethical approval was not required as the data requested from the register holders was provided as aggregated number of DDDs and not as individual level dispensation data. The Ethical Review Act (2003:460) on ethical review of research involving humans in Sweden dictates that ethical approval is needed when processing sensitive personal data, however data in the aggregated form does not allow for the identification of individuals and does not require ethical approval. 3-In discussion section, please add a paragraph about the increase of OTC medication due to the fear of shortage of drugs due to lockdown, people buy a large amount of OTC medication at one time for sticking to the predicted lockdown which occurred in the last of March 2020,....etc 4-Was there an overwhelmed hospitals and clinics during this surge of OTC medication? Because it can be another explanation to that surge as people will try to treat symptoms at home. To address points 3 and 4 by reviewer 2, we have re-written the paragraph about potential reasons why there was an increase in OTC medication sales in March 2020 in lines 304-310 in the clean version: The reasons for the increase in OTC sales cannot be determined from the aggregated data available. However, potential reasons include an increase in the number of individuals experiencing and treating symptoms of illness at home. This is supported by the noted reduction in primary care visits in Sweden during the same time period.[10] Additionally, the increase may be a result of household stockpiling of OTC medications in preparation of illness or due to worry of potential drug shortages or lockdown restrictions. The subsequent decrease in the observed versus predicted sales for the remainder of the year points to sizable amounts of medication stockpiled at the time of purchase in March. Attachments Attachment Submitted filename: PLOS_ONE_response to reviewers.docx https://doi.org/10.1371/journal.pone.0253944.r002
16 Jun 2021 Decision Letter - Sherief Ghozy, Editor Patterns of prescription dispensation and over-the-counter medication sales in Sweden during the COVID-19 pandemic PONE-D-21-06619R1 Dear Dr. Cesta, We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements. Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication. An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. Kind regards, Sherief Ghozy, M.D., Ph.D. candidate Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0253944.r003
Formally Accepted
29 Jul 2021 Acceptance Letter - Sherief Ghozy, Editor PONE-D-21-06619R1 Patterns of prescription dispensation and over-the-counter medication sales in Sweden during the COVID-19 pandemic Dear Dr. Cesta: I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department. If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org. If we can help with anything else, please email us at plosone@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. Sherief Ghozy Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0253944.r004

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