Prescribing Pattern of Anti-Parkinson Drugs in Japan: A Trend Analysis from 2005 to 2010

Abstract

ObjectiveTherapeutic options for Parkinson's disease mainly consist of L-dopa and dopamine agonists. However, in Japan, the product labeling of the ergot dopamine agonists, cabergoline and pergolide, was revised in April 2007 due to the risk of developing cardiac valvulopathy. Here, we describe the prescribing trends of anti-Parkinson drugs from 2005 through 2010 in Japan, and examined whether these trends changed after the drug safety measures in 2007.Methods and PatientsWe used medical claim data from January 2005 to December 2010 for Parkinson's disease patients older than 30 years who were prescribed anti-Parkinson drugs. We calculated the proportion of patients prescribed each drug for each year, and compared the proportions of first-line drugs prescribed before and after April 2007. We also examined the prescription variations of cabergoline/pergolide users one year before or after April 2007.ResultsL-dopa was the most frequently prescribed drug for Parkinson's disease (2005, 58%; 2010, 51%). The proportion of patients prescribed ergot dopamine agonists markedly decreased and non-ergot dopamine agonists increased after 2007. Among first-line drugs, the proportion of non-ergot agents increased after April 2007. Among 54 cabergoline/pergolide users, 24 (44%) discontinued these drugs, nine of whom switched to non-ergot agents.ConclusionL-dopa was the mainstay of Parkinson's disease treatment between 2005 and 2010 in Japan. There was a decrease in ergot agents and an increase in non-ergot agents prescribed after the regulatory actions in 2007.

Adherence to treatment guideline recommendations for Parkinson’s disease in Japan: A longitudinal analysis of a nationwide medical claims database between 2008 and 2016

“…We observed that the non-ergot DA class was the second most prescribed anti-PD drug in patients with newly diagnosed PD and was prescribed mainly in younger patients, as recommended in the 2011 Japanese guidelines. This rate was much lower than that reported in a study using the Japan Medical Data Center database between 2007 and 2010 (29.4%) [13]. The Japan Medical Data Center database contained a much greater proportion of younger patients than the MDV database as it consisted of employment insurance [15].…”

“…Previous database studies from the United States [8][9][10][11], Taiwan [12], and Japan [13] have examined prescribing patterns for PD. However, the Japanese study reported data obtained before publication of the 2011 guidelines, and new anti-PD drugs have been approved and new data regarding the risk of side effects have been reported since then [14].…”

Comparison of zonisamide with non-levodopa, anti-Parkinson's disease drugs in the incidence of Parkinson's disease-relevant symptoms

“…No study has reported the association between the use of zonisamide and the incidence of PD-relevant symptoms in comparison with other anti-PD drugs. Nakaoka et al analyzed claims data that was collected from January 2005 to November 2010 and reported about zonisamide use [35]. However, they mainly reported the prescribing trends of zonisamide as well as other anti-PD drugs.…”

Status of use of protease inhibitors for the prevention and treatment of pancreatitis after endoscopic retrograde cholangiopancreatography: An epidemiologic analysis of the evidence-practice gap using a health insurance claims database

“…Since 1991, evidence-based medicine (EBM) has been adopted in various clinical fields along with an increase in social awareness that seeks high-quality medical care (1). However, it is not always the case that evidencebased medical care is practiced in clinical settings (2)(3)(4)(5)(6)(7). One study reported that guideline-recommended medical care is provided to roughly 50% of adult patients (8).…”