Preferred drug utilization: Treating allergic rhinitis with less-sedating antihistamines

Kirsten M. Kloepfer, Mark E. Helm, Tamara T. Perry, Ping Hu, Stacie M. Jones, Perla Vargas

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: In 2005, Arkansas Medicaid initiated an evidence-based prescription drug program. Loratadine was selected as the preferred less-sedating antihistamine (LSA). Objectives: To examine the impact of using a preferred LSA for treatment of allergic rhinitis (AR) among children enrolled in Medic-aid and the State Children's Health Insurance Program. Methods: LSA claims data for children (aged 2-17 years) diag-nosed with AR alone were retrospectively extracted for 12 months before and after program implementation. Changes in pharmacy claims, healthcare utilization, and costs were analyzed. Results: We identified 11,591 children with AR. After program imple-mentation, loratadine claims increased (479 to 14,448; P <.001), while total LSA claims decreased (19,111 to 15,699; P <.001). A significant increase was seen in claims for leukotriene modifier (2341 to 3289; P <.001) and intranasal steroids (4614 to 5064; P <.001). There were significantly fewer outpatient claims (49,824 to 43,162; P <.001) and emergency department claims (3886 to 3236; P <.001). LSA pharmacy costs for children with AR decreased ($993,410 to $268,853; P <.001). Prior authorization for a nonpre-ferred LSA was requested for only 3% of the patients. Conclusions: Implementation of a preferred drug program for LSA using loratadine resulted in a change in filling patterns and LSA and medical cost reduction, without evidence of increased healthcare utilization. No significant change in overall pharmacy spending was observed, and a shift was seen in utilization of other therapies to treat AR.

Original languageEnglish (US)
JournalAmerican Journal of Pharmacy Benefits
Volume4
Issue number5
StatePublished - Sep 2012

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Histamine H1 Antagonists
Drug Utilization
Loratadine
Costs and Cost Analysis
Prescription Drugs
Allergic Rhinitis
Drug utilization
Leukotrienes
Medicaid
Health Care Costs
Hospital Emergency Service
Outpatients
Steroids
Delivery of Health Care
Health care utilization

ASJC Scopus subject areas

  • Pharmacology, Toxicology and Pharmaceutics (miscellaneous)
  • Business and International Management
  • Decision Sciences (miscellaneous)

Cite this

Preferred drug utilization : Treating allergic rhinitis with less-sedating antihistamines. / Kloepfer, Kirsten M.; Helm, Mark E.; Perry, Tamara T.; Hu, Ping; Jones, Stacie M.; Vargas, Perla.

In: American Journal of Pharmacy Benefits, Vol. 4, No. 5, 09.2012.

Research output: Contribution to journalArticle

Kloepfer, Kirsten M. ; Helm, Mark E. ; Perry, Tamara T. ; Hu, Ping ; Jones, Stacie M. ; Vargas, Perla. / Preferred drug utilization : Treating allergic rhinitis with less-sedating antihistamines. In: American Journal of Pharmacy Benefits. 2012 ; Vol. 4, No. 5.
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abstract = "Background: In 2005, Arkansas Medicaid initiated an evidence-based prescription drug program. Loratadine was selected as the preferred less-sedating antihistamine (LSA). Objectives: To examine the impact of using a preferred LSA for treatment of allergic rhinitis (AR) among children enrolled in Medic-aid and the State Children's Health Insurance Program. Methods: LSA claims data for children (aged 2-17 years) diag-nosed with AR alone were retrospectively extracted for 12 months before and after program implementation. Changes in pharmacy claims, healthcare utilization, and costs were analyzed. Results: We identified 11,591 children with AR. After program imple-mentation, loratadine claims increased (479 to 14,448; P <.001), while total LSA claims decreased (19,111 to 15,699; P <.001). A significant increase was seen in claims for leukotriene modifier (2341 to 3289; P <.001) and intranasal steroids (4614 to 5064; P <.001). There were significantly fewer outpatient claims (49,824 to 43,162; P <.001) and emergency department claims (3886 to 3236; P <.001). LSA pharmacy costs for children with AR decreased ($993,410 to $268,853; P <.001). Prior authorization for a nonpre-ferred LSA was requested for only 3{\%} of the patients. Conclusions: Implementation of a preferred drug program for LSA using loratadine resulted in a change in filling patterns and LSA and medical cost reduction, without evidence of increased healthcare utilization. No significant change in overall pharmacy spending was observed, and a shift was seen in utilization of other therapies to treat AR.",
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