Adoption of new drugs by physicians: a survival analysis

Abstract

BackgroundNew drugs often substitute others cheaper and with a risk-benefit balance better established. Our aim was to analyse the diffusion of new drugs during the first months of use, examining the differences between family physicians and specialists.MethodsPrescription data were obtained of cefditoren, duloxetine, etoricoxib, ezetimibe, levocetirizine, olmesartan, pregabalin and tiotropium 36 months after their launching. We obtained the monthly number of prescriptions per doctor and the number prescribers of each drug by specialty.After discarding those with less than 10 prescriptions during this period, physicians were defined as adopters if the number of prescriptions was over the 25th percentile for each drug and level (primary or secondary care). The diffusion of each drug was studied by determining the number of adopter family physicians throughout the study period. Among the group of adopters, we compared the month of the first prescription by family physicians to that of other specialists using the Kaplan-Meier method.ResultsThe adoption of the drugs in primary care follows an exponential diffusion curve that reaches a plateau at month 6 to 23. Tiotropium was the most rapidly and widely adopted drug. Cefditoren spread at a slower rate and was the least adopted. The diffusion of etoricoxib was initially slowed down due to administrative requirements for its prescription. The median time of adoption in the case of family physicians was 4-6 months. For each of the drugs, physicians of a specialty other than family physicians adopted it first.ConclusionsThe number of adopters of a new drug increases quickly in the first months and reaches a plateau. The number of adopter family physicians varies considerably for different drugs. The adoption of new drugs is faster in specialists. The time of adoption should be considered to promote rational prescribing by providing timely information about new drugs and independent medical education.

Comparing Adoption of Breakthrough and “Me-too” Drugs Among Medicare Beneficiaries: a Case Study of Dipeptidyl Peptidase-4 Inhibitors

“…[4, 5] Nevertheless, our results are consistent with previous studies that found that managed care plans adopt breakthrough therapies faster than traditional plans. [6, 7] The observed seasonal trend in the uptake of both drugs characterized by annual peaks every January is consistent with the “January effect” described in the literature for medication use among Medicare Part D beneficiaries.…”

“…[1] In contrast, “me-too” drugs are new pharmaceuticals with the same mechanism of action of an existing drug and are characterized by a low degree of innovation. [1, 2] Previous researchers have analyzed the diffusion of new drugs, which is the rate at which a new innovation, in this case, a prescription drug, is adopted in a population over time,[3]and have found the time to adoption ranging from 5 months to 8.2 years,[4, 5] and that innovative therapies are adopted quicker in areas with higher managed care penetration. [6, 7] However, no studies have compared the diffusion and adoption patterns of breakthrough and “me-too” drugs.…”

Novel Oral Anticoagulant Use Among Patients With Atrial Fibrillation Hospitalized With Ischemic Stroke or Transient Ischemic Attack

“…15,16 For example, in the first several years following publication of pivotal trials demonstrating warfarin’s efficacy in stroke prevention, such as Atrial Fibrillation, Aspirin, Anticoagulation Study, 1989 (AFASAK) and Stroke Prevention in Atrial Fibrillation Study, 1991 (SPAF), there were only modest increases in warfarin utilization among AF patients from 13% in 1989 to near 25% in 1991. While utilization of anticoagulation for stroke prevention in AF has slowly increased over time, the current anticoagulation rate near 60% suggests there remain opportunities for improvement.…”

Recent Change in Treatment of Disseminated Intravascular Coagulation in Japan

“…21 Information from the pharmaceutical industry may contribute greatly to the awareness of new drugs among clinicians engaged in the treatment of DIC. Second, Garjón et al 22 reported that specialists more rapidly adopt new drugs than do generalists. It is plausible that larger hospitals have more specialists than do smaller hospitals.…”