{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T06:44:18Z","timestamp":1775630658182,"version":"3.50.1"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:00:00Z","timestamp":1760140800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Sahlgrenska Academy, University of Gothenburg"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>In Sweden, oral formulations of diclofenac became prescription-only in 2020, and over the counter (OTC) topical forms were placed behind the counter in 2023. This study investigated the effect of these policy changes on diclofenac dispensed or sold.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Aggregated data on diclofenac dispensed against prescription or sold OTC from January 2019 to February 2024 were analysed descriptively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key findings<\/jats:title>\n                    <jats:p>The volume fell substantially after oral formulations became prescription-only. Placement of topical formulations behind the counter had a more modest effect.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Policy changes have had a significant effect on the volume of diclofenac dispensed or sold in Sweden, especially the prescription requirement.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ijpp\/riaf092","type":"journal-article","created":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T11:43:07Z","timestamp":1758627787000},"page":"212-215","source":"Crossref","is-referenced-by-count":0,"title":["The impact of policy changes on the sales of the environmentally harmful drug diclofenac in Sweden"],"prefix":"10.1093","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8337-7396","authenticated-orcid":false,"given":"Christina","family":"Ljungberg Persson","sequence":"first","affiliation":[{"name":"School of Public Health and Community Medicine, University of Gothenburg , Guldhedsgatan 5A, SE-413 20 Gothenburg ,","place":["Sweden"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebastian","family":"Aronsson","sequence":"additional","affiliation":[{"name":"School of Public Health and Community Medicine, University of Gothenburg , Guldhedsgatan 5A, SE-413 20 Gothenburg ,","place":["Sweden"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5238-1760","authenticated-orcid":false,"given":"Helle","family":"H\u00e5konsen","sequence":"additional","affiliation":[{"name":"School of Public Health and Community Medicine, University of Gothenburg , Guldhedsgatan 5A, SE-413 20 Gothenburg ,","place":["Sweden"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,10,11]]},"reference":[{"key":"2026040801442781300_ref1","doi-asserted-by":"publisher","first-page":"122388","DOI":"10.1016\/j.watres.2024.122388","article-title":"Transformation products of diclofenac: formation, occurrence, and toxicity implication in the aquatic environment","volume":"266","author":"Nosek","year":"2024","journal-title":"Water Res"},{"key":"2026040801442781300_ref2","doi-asserted-by":"publisher","first-page":"630","DOI":"10.1038\/nature02317","article-title":"Diclofenac residues as the cause of vulture population decline in Pakistan","volume":"427","author":"Oaks","year":"2004","journal-title":"Nature"},{"key":"2026040801442781300_ref3","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1016\/j.envint.2015.09.023","article-title":"Balancing the health benefits and environmental risks of pharmaceuticals: diclofenac as an example","volume":"85","author":"Acu\u00f1a","year":"2015","journal-title":"Environ Int"},{"key":"2026040801442781300_ref4","article-title":"Pharmaceuticals and environment [database]","author":"Health and Medical Care Administration, Region Stockholm, Sweden"},{"key":"2026040801442781300_ref5","doi-asserted-by":"publisher","first-page":"296","DOI":"10.1002\/pds.4955","article-title":"Impact of EMA regulatory label changes on systemic diclofenac initiation, discontinuation, and switching to other pain medicines in Scotland, England, Denmark, and the Netherlands","volume":"29","author":"Morales","year":"2020","journal-title":"Pharmacoepidemiol Drug Saf"},{"key":"2026040801442781300_ref6","doi-asserted-by":"publisher","first-page":"100384","DOI":"10.1016\/j.envadv.2023.100384","article-title":"Estimating environmental exposure to analgesic drugs: a cross-sectional study of drug utilization patterns in the area surrounding Sweden\u2019s largest drinking water source","volume":"12","author":"Vill\u00e9n","year":"2023","journal-title":"Environmental Advances"},{"key":"2026040801442781300_ref7","volume-title":"Diklofenak Flyttas Bakom Apoteksdisken","author":"Sveriges Apoteksf\u00f6rening","year":"2023"},{"key":"2026040801442781300_ref8","doi-asserted-by":"publisher","first-page":"100358","DOI":"10.1016\/j.envadv.2023.100358","article-title":"Preferences for medicines with different environmental impact \u2013 a Swedish population-based study","volume":"12","author":"H\u00e5konsen","year":"2023","journal-title":"Environ Adv"},{"key":"2026040801442781300_ref9","doi-asserted-by":"publisher","first-page":"105583","DOI":"10.1016\/j.aquatox.2020.105583","article-title":"Naproxen affects multiple organs in fish but is still an environmentally better alternative to diclofenac","volume":"227","author":"N\u00e4slund","year":"2020","journal-title":"Aquat 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Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ijpp\/article-pdf\/34\/2\/212\/64639901\/riaf092.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ijpp\/article-pdf\/34\/2\/212\/64639901\/riaf092.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T05:44:34Z","timestamp":1775627074000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ijpp\/article\/34\/2\/212\/8283588"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,11]]},"references-count":10,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,10,11]]},"published-print":{"date-parts":[[2026,4,3]]}},"URL":"https:\/\/doi.org\/10.1093\/ijpp\/riaf092","relation":{},"ISSN":["0961-7671","2042-7174"],"issn-type":[{"value":"0961-7671","type":"print"},{"value":"2042-7174","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,4]]},"published":{"date-parts":[[2025,10,11]]}}}