OBJECTIVE: To examine off-label use and costs of antihypertensive drugs in children by using a national sample of prescription claims. METHODS: We conducted a cross-sectional study using the 2002 Medstat MarketScan Database, a national sample of outpatient prescription claims of children <or=18 years old enrolled in private, employer-sponsored health plans. Our main outcomes were off-label use of antihypertensive drugs by patient age and costs of antihypertensives calculated as mean cost per child per 30-day fill. RESULTS: One half of the index antihypertensive prescription claims were off label, based on minimum age criteria. Boys were more likely (56%) than girls (46%) to be prescribed off-label antihypertensives (P < .001). Children aged >or=12 years were more likely to be prescribed off-label antihypertensives (53%) compared with children aged <or=5 (46%) and 6-11 years (42%; P < .001). Off-label use varied significantly by class of antihypertensive drugs (P < .001). Overall, off-label antihypertensives were significantly more expensive than on-label antihypertensives. CONCLUSIONS: Despite availability of often less expensive on-label alternatives for the same class of antihypertensive drugs, off-label antihypertensive drugs were prescribed frequently in children. These findings underscore the potential clinical and economic implications of common off-label prescribing, for children, their parents, physicians, and payers.
OBJECTIVE: To examine off-label use and costs of antihypertensive drugs in children by using a national sample of prescription claims. METHODS: We conducted a cross-sectional study using the 2002 Medstat MarketScan Database, a national sample of outpatient prescription claims of children <or=18 years old enrolled in private, employer-sponsored health plans. Our main outcomes were off-label use of antihypertensive drugs by patient age and costs of antihypertensives calculated as mean cost per child per 30-day fill. RESULTS: One half of the index antihypertensive prescription claims were off label, based on minimum age criteria. Boys were more likely (56%) than girls (46%) to be prescribed off-label antihypertensives (P < .001). Children aged >or=12 years were more likely to be prescribed off-label antihypertensives (53%) compared with children aged <or=5 (46%) and 6-11 years (42%; P < .001). Off-label use varied significantly by class of antihypertensive drugs (P < .001). Overall, off-label antihypertensives were significantly more expensive than on-label antihypertensives. CONCLUSIONS: Despite availability of often less expensive on-label alternatives for the same class of antihypertensive drugs, off-label antihypertensive drugs were prescribed frequently in children. These findings underscore the potential clinical and economic implications of common off-label prescribing, for children, their parents, physicians, and payers.
Authors: S Conroy; I Choonara; P Impicciatore; A Mohn; H Arnell; A Rane; C Knoeppel; H Seyberth; C Pandolfini; M P Raffaelli; F Rocchi; M Bonati; G Jong; M de Hoog; J van den Anker Journal: BMJ Date: 2000-01-08
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