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Pharmacy Variation Utilization and variation for maintenance and scheduled drugs

Pharmacy Variation Utilization and variation for maintenance and scheduled drugs. Nevin Aragam, CNA Analysis and Solutions. Outline.

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Pharmacy Variation Utilization and variation for maintenance and scheduled drugs

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  1. Pharmacy VariationUtilization and variation for maintenance and scheduled drugs Nevin Aragam, CNA Analysis and Solutions

  2. Outline • We investigate Navy pharmacy utilization and variation for FY 2011 to identify and understand patterns among our population of maintenance and scheduled pharmaceutical users • Methods • All drugs • Maintenance drugs • Scheduled drugs FOR OFFICIAL USE ONLY

  3. Methods • FY 2011 PDTS via MDR • Used catchment area of record to identify the eligible populations surrounding navy catchment regions • Identified all eligible beneficiaries in FY 2011 using DEERS and the demographic information from the most recent FM the beneficiary appeared • Maintenance drugs are identified with the MDR PDTS field Maintenance Drug = ‘Y’ • Scheduled drugs and identified using the MDR PDTS field DEA Class = 1, 2, 3, 4, or 5* * note, there were no drugs identified as having DEA class 1 in PDTS FOR OFFICIAL USE ONLY

  4. All pharmacy age distribution Age distribution for all pharmacy users FOR OFFICIAL USE ONLY

  5. All pharmacy utilization 60,000 30 days supplies implies the average 80 year old takes about 5 medications daily 30 day supplies per 1,000 Navy region beneficiaries by age FOR OFFICIAL USE ONLY

  6. Popular fill source • AD beneficiaries fill almost exclusively at MTF pharmacies • Active duty family members and retirees fill mostly at MTFs and a sizable proportion at retail pharmacies • Retirees and their dependents fill fairly evenly across MTFs and retail pharmacies Source: MHS Data Repository (MDR PDTS table FY2011). FOR OFFICIAL USE ONLY

  7. Types of maintenance drugs • Top 5 Maintenance drugs (15% of all maintenance drugs prescribed) • IBUPROFEN • SIMVASTATIN • LISINOPRIL • NEXIUM • LIPITOR FOR OFFICIAL USE ONLY

  8. Maintenance drug age distribution Age distribution for maintenance pharmaceutical users FOR OFFICIAL USE ONLY

  9. Maintenance drug utilization 50,000 30 days supplies implies the average 80 year old takes about 4 maintenance medications daily 30 day supplies of maintenance drugs per 1,000 Navy region beneficiaries by age FOR OFFICIAL USE ONLY

  10. Maintenance drug regional variation High: NH Pensacola (13,307 30 day supplies) Low: NCA MSMA (9,460 30 day supplies) High/Low: 1.41 (Beneficiaries in NH Pensacola use 1.4 times as many maintenance drugs as those in the NCA MSMA) Regional variation for maintenance drug prescriptions per 1,000 beneficiaries FOR OFFICIAL USE ONLY

  11. Scheduled drugs FOR OFFICIAL USE ONLY

  12. Types of scheduled drugs • Top 5 Scheduled drugs (55% of all schedules drugs prescribed) • HYDROCODONE-ACETAMINOPHEN • ZOLPIDEM TARTRATE • OXYCODONE-ACETAMINOPHEN • ALPRAZOLAM • DIAZEPAM • Scheduled drugs can also be maintenance drugs: • CLONAZEPAM • CONCERTA • LYRICA • ADDERALL XR • VYVANSE FOR OFFICIAL USE ONLY

  13. Scheduled drug age distribution Age distribution for scheduled pharmaceutical users FOR OFFICIAL USE ONLY

  14. Scheduled drug utilization 1,900 30 days supplies implies the average 80 year old takes about 1.5 scheduled drug medications daily 30 day supplies of scheduled drugs per 1,000 Navy region beneficiaries by age FOR OFFICIAL USE ONLY

  15. Scheduled drug regional variation High: NH Pensacola (1,073 30 day supplies) Low: NCA MSMA (567 30 day supplies) High/Low: 1.89 (Beneficiaries in NH Pensacola use nearly twice as many scheduled drugs as those in the NCA MSMA) Regional variation for scheduled drug prescriptions per 1,000 beneficiaries FOR OFFICIAL USE ONLY

  16. Questions? • Nevin Aragam • AragamN@CNA.org FOR OFFICIAL USE ONLY

  17. Appendix • Navy region definitions by catchment area DMIS ID: • 0067 0066 0037 0123 - NCA MSMA • 0124 0120 – Tide Water MSMA • 0024 0029 - San Diego MSMA • 0125 126 127 - Puget Sound MSMA • 0104 - NH Beaufort • 0091 - NH Camp Lejeune • 0039 - NH Jacksonville • 0028 - NH Lemoore • 0038 - NH Pensacola • 0030 - NH Twentynine Palms FOR OFFICIAL USE ONLY

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