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Patterns of Prescription Weight-Loss Drug Use. Endocrinologic and Metabolic Drugs Advisory Committee Meeting Rockville, Maryland September 8, 2004 Laura A. Governale, Pharm.D., MBA Drug Utilization Specialist Team Leader Division of Surveillance, Research and Communication Support
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Patterns of Prescription Weight-Loss Drug Use Endocrinologic and Metabolic Drugs Advisory Committee Meeting Rockville, Maryland September 8, 2004 Laura A. Governale, Pharm.D., MBA Drug Utilization Specialist Team Leader Division of Surveillance, Research and Communication Support Office of Drug Safety/CDER
Topics on Prescription Weight-Loss Drug Use • Prescription Weight-Loss Drugs: • Dexfenfluramine • Sibutramine • Orlistat • Amphetamine Congeners • Prescribing Trends • Patient Demographics • Not covered in this analysis: • Over-the-Counter Weight-Loss Drugs • Nutritional Supplements
Topics on Prescription Weight-Loss Drug Use • Prescription Weight-Loss Drugs: • Dexfenfluramine • Sibutramine • Orlistat • Amphetamine Congeners • Prescribing Trends • Patient Demographics • Not covered in this analysis: • Over-the-Counter Weight-Loss Drugs • Nutritional Supplements
Data Sources • IMS Health, National Prescription Audit Plus™ (NPA Plus™) • Measures the “retail outflow” of prescriptions from pharmacies to consumers via prescriptions • Includes: chain, independent, mass merchandisers, food stores with pharmacies, mail-order, and long-term care pharmacies • IMS Health, National Disease and Therapeutic Index (NDTI™) • Survey of roughly 3,000 office-based physician practice patterns in the continental U.S. • Data include profiles and trends of diagnoses, patients and treatment patterns
Prescribing Trends for Prescription Weight-Loss Drugs • Data Source: IMS Health, National Prescription Audit Plus™ (NPA Plus™) • Total Number of Prescriptions Dispensed, 1966 – 2003 • Method of Payment for Prescription Weight-Loss Drugs, 1999 – 2003
IMS Health, National Prescription Audit Plus7™, Years 1997 – 2003, Extracted March 2004, NPA Plus™ Therapeutic Category Report, Years December 1966 -1996, Hard Copy Books
IMS Health, National Prescription Audit Plus7™, Years 1997 – 2003, Extracted March 2004, NPA Plus™ Therapeutic Category Report, Years December 1966 -1996, Hard Copy Books
IMS Health, National Prescription Audit Plus7™, Years 1997 – 2003, Extracted March 2004, NPA Plus™ Therapeutic Category Report, Years December 1966 -1996, Hard Copy Books
IMS Health, National Prescription Audit Plus7™, Years 1999 – 2003, Extracted August 2004
Patient Demographics • IMS Health, National Disease and Therapeutic Index™ (NDTI™) • Principle Diagnoses Associated with Prescription Weight-Loss Drug* Use • Gender Distribution • Age Distribution • Race Distribution *Prescription Weight-Loss Drugs: phentermine, orlistat, sibutramine, phendimetrazine, diethylpropion, benzphetamine, mazindol, fenfluramine, and dexfenfluramine
IMS Health, National Disease and Therapeutic Index™, Years 1998-2003, Extracted September 2004
IMS Health, National Disease and Therapeutic Index™, Years 1998-2003, Extracted September 2004
IMS Health, National Disease and Therapeutic Index™, Years 1998-2003, Extracted September 2004
IMS Health, National Disease and Therapeutic Index™, Years 1998-2003, Extracted September 2004
Limitations • NPA Plus provides only limited demographic information on prescription use • NDTI is based on a sample size of 2000 - 3000 office-based physicians. The small sample size can make these data projections unstable, particularly when use is not highly prevalent. • Data not be generalizable to all obese patients since only patients seen by physicians in office-based settings are represented • Due to the limitations in sampling in this database, any perceived trends must be interpreted with caution.
Conclusions • Drug use for prescription weight-loss drugs has fluctuated over the last 38 years and has declined in recent years. • Cash payment remains an important mechanism for payment for these drugs. • The primary users of these products are Caucasian women between the ages of 18-44.
Acknowledgements • Gerald DalPan, M.D., MHS, Division of Surveillance, Research and Communication Support • Eric Colman, M.D., Division of Metabolic and Endocrine Drug Products • Bruce Stadel, M.D., Division of Metabolic and Endocrine Drug Products • Anne Trontell, M.D., MPH, Office of Drug Safety