The Impact of New Drug Introduction on Drug Expenditure in Primary Health Care in Catalunya, Spain

Zara, Corinne; Torralba, Miguel; Sotoca, JM; Prat, A; Faixedas, María-Teresa; Gilabert, Antoni Coll

doi:10.1345/aph.1e236

Cited by 10 publications

(3 citation statements)

References 14 publications

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“…The substitution of established therapies for new drugs is often inappropriate because of lack of improvements in effectiveness, when unknown side effects cannot be ruled out at the time of marketing [5] and the prices are disproportionate to the alleged benefits [6,7]. However, a delayed uptake of effective innovations supported by clinical investigation has also been observed, resulting in non-optimal treatments for some patients [8].…”

Section: Introductionmentioning

confidence: 99%

Adoption of new drugs by physicians: a survival analysis

Garjón

Azparren

Vergara

et al. 2012

BMC Health Serv Res

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BackgroundNew drugs often substitute others cheaper and with a risk-benefit balance better established. Our aim was to analyse the diffusion of new drugs during the first months of use, examining the differences between family physicians and specialists.MethodsPrescription data were obtained of cefditoren, duloxetine, etoricoxib, ezetimibe, levocetirizine, olmesartan, pregabalin and tiotropium 36 months after their launching. We obtained the monthly number of prescriptions per doctor and the number prescribers of each drug by specialty.After discarding those with less than 10 prescriptions during this period, physicians were defined as adopters if the number of prescriptions was over the 25th percentile for each drug and level (primary or secondary care). The diffusion of each drug was studied by determining the number of adopter family physicians throughout the study period. Among the group of adopters, we compared the month of the first prescription by family physicians to that of other specialists using the Kaplan-Meier method.ResultsThe adoption of the drugs in primary care follows an exponential diffusion curve that reaches a plateau at month 6 to 23. Tiotropium was the most rapidly and widely adopted drug. Cefditoren spread at a slower rate and was the least adopted. The diffusion of etoricoxib was initially slowed down due to administrative requirements for its prescription. The median time of adoption in the case of family physicians was 4-6 months. For each of the drugs, physicians of a specialty other than family physicians adopted it first.ConclusionsThe number of adopters of a new drug increases quickly in the first months and reaches a plateau. The number of adopter family physicians varies considerably for different drugs. The adoption of new drugs is faster in specialists. The time of adoption should be considered to promote rational prescribing by providing timely information about new drugs and independent medical education.

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Section: Introductionmentioning

confidence: 99%

Adoption of new drugs by physicians: a survival analysis

Garjón

Azparren

Vergara

et al. 2012

BMC Health Serv Res

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“…14 The main problem of implementing generics in any significant form in Spain is the lack of tradition in the use of such drugs, due in large part to the lack of information for healthcare professionals and the fact that there is no official list of generic drugs. 15,16 In a study performed in health centres in Barcelona, Valles et al 17 regarding the substitution of branded drugs for their respective generics. A total of 98.9% of these patients accepted the change and of those who rejected this, 40% did so on the advice of other doctors (specialists and private doctors, etc).…”

Section: Discussionmentioning

confidence: 99%

Analysis of prescriptions given on discharge from the emergencies department. Economic impact

Ruiz-López

Hernández

Manzorro

et al. 2009

Farmacia Hospitalaria (English Edition)

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“…Because head‐to‐head trials of newer and older drug comparators are not required before product launch, new drugs may be approved based only on proof of efficacy relative to placebos, not relative to existing agents. Nonetheless, prescribers appear ready to adopt new pharmaceuticals quickly, 8–10 particularly when there is no direct incentive to employ older, less‐expensive options, at least as first‐line therapy. In addition, practice guidelines may recommend use of newer medications as first‐line therapy 11 .…”

Section: Discussionmentioning

confidence: 99%