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01.12.2012 | Research article | Ausgabe 1/2012 Open Access

BMC Health Services Research 1/2012

Adoption of new drugs by physicians: a survival analysis

Zeitschrift:
BMC Health Services Research > Ausgabe 1/2012
Autoren:
Francisco Javier Garjón, Ana Azparren, Iván Vergara, Borja Azaola, Jose Ramón Loayssa
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1472-6963-12-56) contains supplementary material, which is available to authorized users.

Competing interests

IV has received payment for educational presentations from Novartis and Esteve. BA has received payment for educational presentations from GSK and reimbursement of travel expenses from MSD and Pfizer. JRL has received payment for educational presentations from Novartis and reimbursement of travel expenses from Esteve, Novartis and Pfizer. Both FJG and AA declare that they have no conflict of interest.

Authors' contributions

All authors participated in the design of the study and the discussion of findings. FJG and AA executed the data management. JRL drafted the manuscript. FJG, AA, IV and BA revised the manuscript. All authors read and approved the final manuscript.

Abstract

Background

New 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.

Methods

Prescription 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.

Results

The 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.

Conclusions

The 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.
Zusatzmaterial
Authors’ original file for figure 1
12913_2011_1989_MOESM1_ESM.doc
Authors’ original file for figure 2
12913_2011_1989_MOESM2_ESM.pdf
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