National Trends in Ambulatory Asthma Treatment, 1997–2009

Higashi, Ashley S.; Zhu, Shu Hong; Stafford, Randall S.; Alexander, G. Caleb

doi:10.1007/s11606-011-1796-4

Cited by 35 publications

(31 citation statements)

References 7 publications

(5 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In contrast, when measured using the ratio of LTC-Rx claims to total asthma drug claims, LTC-Rx adherence was associated with a 23.0% lower likelihood of having an asthma exacerbation (adjusted odds ratio (AOR) = 0.77 [95% CI, 0.75–0.80]) [24]. National survey data indicate that this ratio has increased across the US population of persons with asthma from 0.5 in 1997 to a peak of 0.7 in 2004 [25]. …”

Section: Discussionmentioning

confidence: 99%

Inhaled corticosteroid adherence and emergency department utilization among Medicaid-enrolled children with asthma

2013

View full text Add to dashboard Cite

Objectives Asthma is the most prevalent chronic disease among children enrolled in Medicaid. This study measured real-world adherence and outcomes after an initial prescription for inhaled corticosteroid therapy in a multi-state Medicaid population. Methods We conducted a retrospective study among Medicaid-enrolled children aged 5–12 years with asthma in 14 southern states using 2007 Medicaid Analytic eXtract file claims data to assess adherence and outcomes over the 3 months following an initial prescription drug claim for inhaled corticosteroids (ICS-Rx). Adherence was measured by the long-term controller-to-total asthma drug claims ratio. Results Only one-third of children (33.4%) with an initial ICS-Rx achieved a controller-to-total drug ratio >0.5 over the next 90 days. Children for whom long-term control drugs represented less than half of their total asthma drug claims had a 21% higher risk of emergency department (ED) visit (adjusted odds ratio (AOR) 1.21 [95% CI 1.14, 1.27]), and a 70% higher risk of hospital admission (AOR 1.70 [95% CI 1.45, 1.98]) than those with a controller-to-total asthma drug ratio >0.5. Conclusion Real-world adherence to long-term controller medications is quite low in this racially diverse, low-income segment of the population, despite Medicaid coverage of medications. Adherence to long-term controller therapy had a measurable impact on real-world outcomes. Medicaid programs are a potential surveillance system for both medication adherence and ED utilization.

show abstract

Section: Discussionmentioning

confidence: 99%

Inhaled corticosteroid adherence and emergency department utilization among Medicaid-enrolled children with asthma

2013

View full text Add to dashboard Cite

show abstract

“…We limited our analyses to the approximately 85% of contacts generated through office visits. Previous studies have compared the NDTI with the National Ambulatory Medical Care Survey, a nationally representative survey conducted by the National Center for Health Statistics; these studies have suggested that both data sources provide similar estimates of office-based medication use (26–28). …”

Section: Methodsmentioning

confidence: 99%

Effects of FDA Advisories on the Pharmacologic Treatment of ADHD, 2004–2008

Kornfield¹,

Watson²,

Higashi³

et al. 2013

Self Cite

View full text Add to dashboard Cite

Objective This study assessed the effect of public health advisories issued between 2005 and 2007 by the U.S. Food and Drug Administration (FDA) on treatments of attention-deficit hyperactivity disorder (ADHD) and physician prescribing practices. Methods Data obtained from the IMS Health National Disease and Therapeutic Index, a nationally representative audit of ambulatory physicians, were used to examine trends in office visits by children and adolescents (under age 18) during which ADHD was treated with Adderall, other psychostimulants, or atomoxetine. Segmented time series regressions were conducted to determine changes in use associated with three advisories issued between 2005 and 2007. Results In 2004, before the first FDA advisory, Adderall accounted for 36% of ADHD pharmacotherapy treatment visits. Other stimulants accounted for 46%, and atomoxetine accounted for 19%. Overall pharmacotherapy treatment rates were stable over the study period, but by 2008 the treatment visits accounted for by Adderall (that is, market share) declined to 24%, and the market share for atomoxetine declined to 8%. The market share for substitute therapies—clonidine, guanfacine, and bupropion—was stable over this period, ranging from 5% to 7%. Despite the declines in the use of Adderall and atomoxetine over the study period, results from the regression models suggest that the advisories did not have a statistically significant effect on ADHD medication prescribing. Conclusions FDA advisories regarding potential cardiovascular and other risks of ADHD medications had little discernible incremental effect on the use of these medicines in this nationally representative ambulatory audit.

show abstract

“…Our analysis was not designed to distinguish between clinically appropriate use and overuse of the medicines examined, because data that would allow for such inferences (e.g., detailed information regarding patients' histories, diagnoses, comorbid conditions, treatment failures, and preferences) were not available to us. Both underuse and overuse of therapies, such as those that we examined, have been previously documented (12,29), and as with provider-targeted pharmaceutical advertising, the evidence regarding DTCA's impact is mixed (30). Despite this, the preponderance of evidence suggests that pharmaceutical advertising is associated with increased prescribing frequency, higher costs, or lower quality as assessed by concordance with clinical guidelines (7,31).…”

Section: Discussionmentioning

confidence: 90%

“…We examined the association between DTCA, asthma medication sales, and asthma-related healthcare use by linking data capturing household exposure to DTCA to two separate datasets: the IMS Health National Prescription Audit (pharmacy sales) and the MarketScan Commercial Claims database (prescription and nonprescription healthcare use). We focused on asthma because of its high prevalence and cost (12,13). We hypothesized that DTCA exposure would be associated with increases in the market share for advertised drugs, expansion of the overall therapeutic class of advertised products, and increases in asthma-related healthcare use.…”

mentioning

confidence: 99%

Effect of Direct-to-Consumer Advertising on Asthma Medication Sales and Healthcare Use

Daubresse

Hutfless

Kim³

et al. 2015

Am J Respir Crit Care Med

Self Cite

View full text Add to dashboard Cite

Rationale: The United States is one of only two countries that permit direct-to-consumer advertising (DTCA) of prescription drugs, and many questions remain regarding its effects.Objectives: To quantify the association between asthma-related DTCA, pharmacy sales, and healthcare use.Methods: This was an ecological study from 2005 through 2009 using linked data from Nielsen (DTCA television ratings), the IMS Health National Prescription Audit (pharmacy sales), and the MarketScan Commercial Claims data (healthcare use) for 75 designated market areas in the United States. We used multilevel Poisson regression to model the relationship between DTCA and rates of prescriptions and use within and across designated market areas. Main outcome measures include (1) volume of total, new, and refilled prescriptions for advertised products based on pharmacy sales; (2) prescription claims for asthma medications; and asthma-related (3) emergency department use, (4) hospitalizations, and (5) outpatient encounters among the commercially insured.Measurements and Main Results: Four Food and Drug Administration-approved asthma medicines were advertised during the period examined: (1) fluticasone/salmeterol (Advair), (2) mometasone furoate (Asmanex), (3) montelukast (Singulair), and (4) budesonide/ formoterol (Symbicort). After adjustment, each additional televised advertisement was associated with 2% (incident rate ratio, 1.02; 95% confidence interval, 1.01-1.03) higher pharmacy sales rate from 2005 through 2009, although this effect varied across the three consistently advertised therapies examined. Among the commercially insured, DTCA was positively and significantly associated with emergency room visits related to asthma (incident rate ratio, 1.02; 95% confidence interval, 1.01-1.04), but there was no relationship with hospitalizations or outpatient encounters.Conclusions: Among this population, DTCA was associated with higher prescription sales and asthma-related emergency department use.

show abstract

National Trends in Ambulatory Asthma Treatment, 1997–2009

Cited by 35 publications

References 7 publications

Inhaled corticosteroid adherence and emergency department utilization among Medicaid-enrolled children with asthma

Inhaled corticosteroid adherence and emergency department utilization among Medicaid-enrolled children with asthma

Effects of FDA Advisories on the Pharmacologic Treatment of ADHD, 2004–2008

Effect of Direct-to-Consumer Advertising on Asthma Medication Sales and Healthcare Use

Contact Info

Product

Resources

About