Background
Recent price increases in medications used to treat helminth infections have had demonstrated impacts on Medicaid and immigrant patient populations. Helminth infections are common within the U.S. military; however, anthelmintic prescribing patterns and costs have not yet been investigated in this patient population.
Methods
We conducted a retrospective analysis of pharmaceutical data from the Military Health System Data Repository between fiscal years 2012-2019. Prescription information, including costs and demographics, were abstracted for all anthelmintic medications as well as associated helminth diagnostic codes within 30 days of the prescription dispensing date.
Results
On average, there were 10,871 anthelmintic medications prescribed per year for a total of 86,697 during the study period. Ivermectin and albendazole were each prescribed more than 34,000 times. There were 15,498 mebendazole prescriptions and 1,327 praziquantel prescriptions. The total cost of all anthelmintic prescriptions was $16,018,381. Annual costs for anthelmintic medications increased by 16-fold during the study period, up to nearly $5,000,000 in fiscal year 2019, primarily driven by price increases in albendazole and mebendazole. Albendazole prescriptions accounted for $12,282,891 of total costs (76.7%), though only 39.1% of total prescriptions. The most common diagnosis associated with albendazole and mebendazole prescriptions was enterobiasis.
Conclusions
Price increases in anthelmintic medications have significantly impacted the costs borne by the U.S. government for treating parasitic infections. There are a substantial number of anthelmintic prescriptions in the U.S. military health care system annually, suggesting a higher number of helminth infections than previously thought.