Objectives: The common pharmacotherapy for Attention Deficit Hyperactivity Disorder (ADHD) includes the use of stimulants and non-stimulants. The objective of this study was to examine the prescribing practices of ADHD medications based on physician specialties and to determine the factors associated with their prescription among children and adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD). Methods: This retrospective cross-sectional study used the National Ambulatory Medical Care Survey data (NAMCS) from 2011-2016. The study included children and adolescents (aged 4-17 years) with a diagnosis of ADHD identified using the International Classification of Diseases (ICD-9-CM ad ICD-10-CM) codes. Descriptive weighted analysis examined the prescribing practices of stimulants and non-stimulants, while multivariable logistic regression evaluated factors associated with ADHD medication use in general, and non-stimulants use in specific among children with ADHD. Results: During the study period, there were 50.3 million (95% CI: 42.5-58.1) visits by children and adolescents with ADHD. Most of patients were boys (69.85%), White (84.58%), and aged 9-12 years (39.84%). ADHD medications were prescribed in 79.80% of the patients. Stimulant medications were mainly prescribed by pediatricians (53.65%), while non-stimulants were mainly prescribed by psychiatrists (50.95%). The multivariable logistic regression revealed that Hispanics ([OR] = 0.55, 95% CI: 0.37-0.82) had a lower likelihood of being prescribed ADHD medications, while patients from South region (OR = 2.02, 95% CI: 1.19-3.42) had a greater likelihood of being prescribed ADHD medications as compared to West region. For non-stimulants, Hispanics (OR = 0.43, 95% CI: 0.19-0.97) were associated with a lower likelihood of non-stimulant prescription. Pediatric specialty (OR = 0.34, 95% CI: 0.12-0.97) was associated with decreased likelihood of prescribing nonstimulant medications, compared to psychiatric specialty. Conclusions: Stimulants and non-stimulants were commonly prescribed among children and adolescents with ADHD. Various demographic and provider factors were associated with prescription of ADHD medications.
patient, resulting in cost savings and QALY gains compared to nusinersen; i.e., AVXS-101 was dominant over nusinersen. In a scenario where sitting gene therapy patients experienced survival trajectory of walking patients, AVXS-101 undiscounted QALYs were 57.5 (if discounted at 3%: 21.9) and AVXS-101 again dominated nusinersen at a price of $3M. Conclusions: AVXS-101 is cost-effective compared to nusinersen and may deliver up to 57.5 QALYs (undiscounted). Discounting QALYs at the US standard rate of 3% results in a substantial underestimate of health benefits. Decision makers such as NICE consider undiscounted QALY gain in certain cases. We recommend that US-based decision makers also consider undiscounted QALY gain when assessing the value of innovative therapies.
Conclusions: After its approval, the recommendations and utilization of hydroxocobalamin as therapy have seen a significant increase, while amyl nitrite as therapy has seen a gradual decrease. Sodium nitrite as therapy has seen no change.
Descriptive weighted analyses were used to examine the trends in opioid prescribing practices for RA. Multivariable logistic regression was used to examine the factors associated with receiving opioid prescriptions among RA visits. Results: Overall, there were 4.45 (95% CI, 2.30-6.60) million adult outpatient visits annually with a primary diagnosis of RA. About one in five visits (21.53%) resulted in opioid prescriptions. The number of RA visits involving opioid prescriptions increased from 1.26
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