OBJECTIVES : Traditional Chinese Medicine (TCM) has over 3000 years’ history for treatment across therapeutic areas and conditions in China. Concomitant use of prescription (Rx) and over-the-counter (OTC) medications has also been recommended in clinical practice guidelines. This study aims to describe Rx, OTC, and TCM treatment trends for mental health conditions in China between 2009 and 2017.

METHODS : Data were obtained from the 2009 and 2017 China National Health and Wellness Survey. Rx-use for treatment of patients currently experiencing anxiety (AX), attention deficit disorder (AD), attention deficit hyperactivity disorder (ADH), depression (DP), bipolar disorder (BI), generalized anxiety disorder (GAD), obsessive compulsive disorder (OCD), panic disorder (PD), phobias (PH), and social anxiety disorder (SAD) was examined. Additional analyses comparing Rx- and OTC/TCM-use for treatment of patients ever experiencing AX or DP was also performed.

RESULTS : Rx-use was consistently higher in 2009 compared to 2017. Across conditions, Rx-use ranged from 9.8% (SAD) to 22% (ADH) in 2009, compared to 4.3% (PD) to 16.8% (DP) in 2017 (4.3% (PD) to 8% (AX) when excluding DP). Trends in DP treatment between 2009 to 2017 were: decreased exclusive Rx-use (13.3% to 4.9%), stable concomitant Rx- and OTC/TCM-use (6.7% to 7.9%), and increased exclusive OTC/TCM-use (9% to 34.7%). Trends in AX treatment followed a similar pattern: decreased exclusive Rx-use (7% to 2.2%), stable concomitant Rx- and OTC/TCM-use (5.1% to 4.8%), and increased exclusive OTC/TCM-use (9.9% to 36.3%).

CONCLUSIONS : Rx-use for treatment of all mental health conditions has decreased in China over time, while OTC/TCM-use for treatment of DP and AX have increased. Decreasing Rx-use and increasing OTC/TCM-use for DP and AX may be related to the disease-specific lower costs of OTC/TCM compared to Rx, and changes in government reimbursement policies. The impact of Rx-use vs. OTC/TCM-use on patient reported outcomes should be explored in future studies.