C24. The utilization of a new nonsteroidal anti-inflammatory drug in a health maintenance organization

C24. The utilization of a new nonsteroidal anti-inflammatory drug in a health maintenance organization

CLINICAL THERAPEUTICS” C24. The Utilization of a New Nonsteroidal Anti-Inflammatory Drug in a Health Maintenance Organization J. Rader’ and B. Goppol...

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CLINICAL THERAPEUTICS”

C24. The Utilization of a New Nonsteroidal Anti-Inflammatory Drug in a Health Maintenance Organization J. Rader’ and B. Goppoldz ‘Temple University Graduate Program and 2Aetna Pharmucy Management Nonsteroidal anti-inflammatory drugs (NSAIDs) represent a significant proportion of the pharmacy budget provided to members of any health maintenance organization (HMO). HMOs would like the pharmacy benefit managers (PBMs) to control the cost of the prescription benefit while maximizing the quality of outpatient care. For this study, a sponsor PBM has selected a population of patients from one of their managed network HMOs who were prescribed the new NSAID, oxaprozin (approved by the US Food and Drug Administration, December 1993) between an 18-month time interval, January 1993 and June 1994. The only inclusion criteria was at least one oxaprozin prescription in the study period. A total of 169 patient pharmacy profiles were qualified and analyzed. Comprehensive prescription profiles for the qualified patients were provided with drug prescribed, dosage strength, number of units, claim cost, date of prescription, and prescribing medical specialty. The HMO selected operates an “open” formulary with unrestricted therapeutic agent selection by the participating physicians. There were 302 prescriptions filled in the selected population for oxaprozin with an average claim cost of $51.26. For the same population, there were 332 prescriptions filled with “all-other” NSAIDs with an average claim cost of $41.37. Internal medicine specialists prescribed 39% of the total oxaprozin prescriptions worth 49% of the total dollars, with general practitioners/family practice specialists prescribing 24% of the total oxaprozin prescriptions representing 25% of the total oxaprozin dollars. Oxaprozin was the only prescribed NSAID in 46% of the patients; 54% of patients switched to or from “all other” NSAIDs with at least one oxaprozin prescription. Gastrointestinal side effects are often associated with NSAID usage and therefore prescription records for gastrointestinal medications were monitored for the selected population. This study will serve to launch future work in support of delivering a quality, economical pharmacy benefit to HMO clients in conjunction with their disease management programs.

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