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J Clin Endocrinol Metab. 2019 Jan 25. doi: 10.1210/jc.2018-02197. [Epub ahead of print]

Generic and Brand-Name Thyroid Hormone Drug Use among Commercially-Insured and Medicare Beneficiaries, 2007-2016.

Author information

1
Section of General Internal Medicine and the National Clinician Scholars Program, Yale School of Medicine, New Haven, CT.
2
Department of Health Policy and Management, Yale School of Public Health, New Haven, CT.
3
Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT.
4
Yale School of Medicine, New Haven, CT.
5
Division of Health Care Policy & Research, Mayo Clinic, Rochester, MN.
6
Division of Endocrinology, Diabetes, Metabolism, Nutrition, Department of Internal Medicine, Mayo Clinic, Rochester, MN.
7
Office of New Drugs, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, White Oak, MD.
8
Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, White Oak, MD.
9
Office of Women's Health, U.S. Food and Drug Administration, White Oak, MD.
10
Section of Endocrinology and Metabolism, Department of Internal Medicine, Yale School of Medicine.
11
Office of Minority Health, U.S. Food and Drug Administration, White Oak, MD.
12
Office of Generic Drugs, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, White Oak, MD.
13
Office of Biostatistics, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, White Oak, MD.

Abstract

Context:

Generic drugs account for 9 out of 10 prescriptions dispensed in the U.S., but for a fewer proportion of commonly prescribed thyroid hormone replacement therapies.

Objective:

Characterize temporal patterns of generic and brand-name thyroid hormone drug use, including patient and prescriber characteristics associated with brand-name use.

Design and Setting:

Cross-sectional longitudinal analysis of national data from a large administrative claims database from January 2007 through December 2016.

Patients:

Adults with insurance coverage through commercial, Medicare Advantage and Medicare Part D health plans.

Main Outcome Measures:

Generic and brand-name thyroid hormone drug use.

Results:

From 2007 to 2016, the annual number of thyroid hormone treatment pharmacy fills increased from 8,905,836 in 2007 to 11,613,923 in 2016, 73.6% of which were for generic levothyroxine, 23.4% for brand-name levothyroxine, and the remaining for other formulations. Dispensing of generic thyroid hormone drugs increased from 59.8% in 2007 to 84.9% in 2016 and was consistently higher among Medicare Advantage and Medicare Part D when compared with the commercial beneficiary population. For all three beneficiary populations, use of brand-name products was less common among older adults and more common among women and those receiving prescriptions from endocrinologists, as well as more common among those of white race and with greater household income for the Medicare Advantage and commercial beneficiary populations (p-values <0.001).

Conclusions:

Brand-name thyroid hormone product use declined from 2007 to 2016 among three large, national insurer beneficiary populations. While certain patient characteristics were associated with brand-name use, prescriber specialty was the strongest predictor.

PMID:
30690529
DOI:
10.1210/jc.2018-02197

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