The Impact of the Women's Health Initiative on Hormone Replacement Therapy in a Medicaid Program

Abstract

The WHI influenced all types of HRT use among postmenopausal women in a Medicaid program. Administrative claims data can be a useful tool for monitoring an immediate impact of national guidelines or a national level outcomes trial.

HRT use in 2001 and 2004 in The Netherlands—A world of difference

“…Hersh et al showed a 37% decrease of HRT prescriptions in 2003 compared with 1999 but in another study in a lower educated population (Medicaid program) the decline was less pronounced [19]. In a survey among HRT-users in New Zealand 40% stopped the use of HRT [20]. Our results .…”

Osteoporosis Management in a Medicaid Population after the Women's Health Initiative Study

“…As expected, a reduction in HT use after the WHI publication was reported in a few studies. [6][7][8][9][10][11] Our study findings showed no apparent changes in overall AOM prevalence, reduction in LEE ET AL. 158 estrogen use, and increases in nonestrogen type AOM, suggesting a potential switch from estrogen to nonestrogen type AOM modalities, although we did not evaluate the switching issue on an individual prescription level.…”

“…6 As the study focused only on the antiresorptive properties of estrogens in HT formulations, we excluded drug entities containing only progesterone as a single agent and combination products of progesterone without estrogens. We included alendronate, risedronate, etidronate, pamidronate, tiludronate, and zoledronate as bisphosphonates.…”

“…Because osteoporosis is a disease requiring long-term treatment if not prevented, women will likely need to be shifted from HT to other antiosteoporosis medications (AOMs) in order to continuously receive the beneficial effects of drug therapy on bone. Given the important therapeutic recommendations of the WHI publication and the documented impact of the study on HT use by several studies, [6][7][8][9][10][11] it is important to understand how these changes affect the management of osteoporosis in a vulnerable population, such as Medicaid recipients, with a lower socioeconomic status. The primary goal of this study was to evaluate the extent of osteoporosis prevention and treatment with AOM before and after release of the WHI results.…”

Dynamics of progestogenic activity in serum following administration of Ligusticum chuanxiong

“…The search for synthetic progestogens with favorable risk-benefit profiles is an area of intense pharmaceutical activity (Williams and Sigler, 1998;Sitruk-Ware, 2004;Turgeon et al, 2004;Rossouw et al, 2002;Anderson et al, 2004). Nevertheless under these circumstances, millions of women globally have decided to discontinue drugs containing synthetic sex steroids (Hillman et al, 2004;McIntosh and Blalock, 2005). Health care professionals are considering (North American Menopause Society, 2004;Krebs et al, 2004), and many women have elected to use botanical alternatives for hormone replacement therapy (HRT) (Beck et al, 2005).…”