Background
Methods
Drug | Launching | Degree of therapeutic Innovation* | Approved indications | Cost/DDD | Alternatives (cost/DDD) |
---|---|---|---|---|---|
Cefditoren
| Sep-04 | No therapeutic innovation | Pneumonia, exacerbation of chronic bronchitis, pharyngitis, tonsillitis, skin infections | €4.47 -6.26 | Amoxicillin-clavulanate (€0.68) Cefuroxime axetil (€2.27) |
Duloxetine
| Dec-05 | No therapeutic innovation | Neuropathic pain, depresión, generalised anxiety disorder (from jul-08) | €1.99 | Amitriptyline (€0.11) Fluoxetine (€0.24) Paroxetine (€0.79) |
Etoricoxib
| Jul-04 | No therapeutic innovation | Osteoarthritis, rheumatoid artritis, acute gouty artritis, ankylosing spondylitis (from sep-08) | €1.74 | Ibuprofen (€0.24) Diclofenac (€0.17) Naproxen (€0.38) |
Ezetimibe
| Mar-04 | Insufficient evidence | Primary hypercholesterolaemia, homozygous familial hypercholesterolaemia, homozygous sitosterolaemia | €1.91 | |
Levocetirizine
| Apr-03 | No therapeutic innovation | Allergic rhinitis, chronic idiopathic urticaria | €0.56 | Cetirizine (€0.29) |
Olmesartan
| May-04 | No therapeutic innovation | Hypertension | €0.92 | Losartan (€0.92) Enalapril (€0.13) |
Pregabalin
| Jan-05 | No therapeutic innovation | Neuropathic pain, epilepsy, generalised anxiety disorder (from mar-06) | €2.57 | Gabapentin (€0.19) Amitriptyline (€0.11) |
Tiotropium
| Jan-03 | Modest therapeutic innovation | Chronic obstructive pulmonary disease | €1.91 | Ipratropium (€0.28) |
Results
Prescribing family physicians and mean of prescriptions
Month since launching | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
2 | 3 | 6 | 12 | 24 | 36 | |||||||
n |
Mean (SD)
| n |
Mean (SD)
| n |
Mean (SD)
| n |
Mean (SD)
| n |
Mean (SD)
| n |
Mean (SD)
| |
Cefditoren
| 7 | 3.6 (4.2)
| 26 | 2.3 (1.9)
| 30 | 3.4 (2.8)
| 32 | 3.3 (5.7)
| 44 | 2.0 (2.2)
| 51 | 2.6 (2.8)
|
Duloxetine
| 38 | 1.5 (0.9)
| 67 | 2.0 (1.5)
| 125 | 2.4 (2.0)
| 172 | 3.5 (2.7)
| 176 | 5.1 (3.8)
| * | * |
Etoricoxib
| 14 | 1.1 (0.4)
| 32 | 1.6 (0.9)
| 41 | 1.4 (0.6)
| 44 | 1.5 (0.8)
| 48 | 1.9 (1.3)
| 124 | 3.1 (4.0)
|
Ezetimibe
| 31 | 2.0 (1.4)
| 59 | 2.0 (1.5)
| 94 | 2.3 (1.9)
| 148 | 2.7 (2.5)
| 200 | 4.0 (3.6)
| 191 | 4.6 (3.8)
|
Levocetirizine
| 8 | 1.6 (0.9)
| 9 | 1.6 (0.7)
| 21 | 1.2 (0.4)
| 75 | 2.2 (1.6)
| 132 | 2.4 (1.7)
| 158 | 3.0 (2.8)
|
Olmesartan
| 36 | 1.8 (1.0)
| 49 | 2.2 (1.3)
| 89 | 2.3 (1.7)
| 131 | 3.4 (3.7)
| 165 | 4.1 (4.8)
| 182 | 4.7 (5.5)
|
Pregabalin
| 14 | 1.3 (0.5)
| 31 | 1.7 (1.4)
| 80 | 1.8 (1.0)
| 137 | 2.3 (1.8)
| 181 | 3.7 (2.7)
| 198 | 5.1 (3.6)
|
Tiotropium
| 80 | 2.3 (1.6)
| 127 | 2.9 (2.4)
| 215 | 3.5 (2.6)
| 244 | 5.9 (4.0)
| 264 | 7.4 (4.9)
| 264 | 8.5 (5.4)
|
Rate of adoption of the drugs among physicians in each specialty
Time of adoption | ||||||
---|---|---|---|---|---|---|
Drug | Specialty | Number of prescribers | Number of adopters (%) | Median in months (intercuartile range) | Comparison with Family Physicians. Log-rank test | |
χ
2
|
p-value
| |||||
Cefditoren
| Otolaryngology | 19 | 11 (58%) | 2 (2-5) | 6.76 | 0.01 |
Family physicians
|
232
|
50 (22%) |
4 (3-7)
| |||
Internal medicine | 22 | 4 (18%) | 5 (3-10) | 0.44 | NS | |
Emergencies | 65 | 7 (11%) | 9 (5-21) | 6.39 | 0.01 | |
Pneumology | 15 | 7 (47%) | 9 (8-12) | 1.14 | NS | |
Duloxetine
| Psychiatry | 36 | 22 (61%) | 2 (2-3) | 29.55 | < 0.01 |
Family physicians
|
252
|
160 (63%) |
4 (3-6)
| |||
Etoricoxib
| Rheumatology | 6 | 3 (50%) | 2 (1-8) | 8.08 | < 0.01 |
Traumatology | 55 | 21 (38%) | 3 (2-15) | 1.97 | NS | |
Family physicians
|
230
|
105 (46%) |
10 (3-20)
| |||
Rehabilitation | 14 | 2 (14%) | 11 (11-26) | 0.51 | NS | |
Ezetimibe
| Cardiology | 16 | 6 (38%) | 2 (1-3) | 8.13 | < 0.01 |
Endocrinology | 11 | 8 (73%) | 3 (2-3) | 10.95 | < 0.01 | |
Family physicians
|
258
|
168 (65%) |
5 (3-8)
| |||
Levocetirizine
| Otolaryngology | 19 | 8 (42%) | 1 (1-4) | 24.14 | < 0.01 |
Allergology | 10 | 10 (100%) | 4 (2-7) | 4.96 | 0.03 | |
Emergencies | 44 | 4 (9%) | 4 (4-12) | 0.73 | NS | |
Dermatology | 15 | 12 (80%) | 9 (2-12) | 1.54 | NS | |
Family physicians
|
264
|
141 (53%) |
10 (7-13)
| |||
Olmesartan
| Cardiology | 15 | 3 (20%) | 1 (1-2) | 17.23 | < 0.01 |
Internal medicine | 21 | 3 (14%) | 2 (2-13) | 0.04 | NS | |
Family physicians
|
256
|
154 (60%)
|
6 (3-9)
| |||
Pregabalin
| Anesthesiology | 8 | 3 (38%) | 2 (2-5) | 8.45 | < 0.01 |
Neurology | 17 | 8 (47%) | 3 (2-4) | 12.1 | < 0.01 | |
Rheumatology | 6 | 6 (100%) | 3 (2-4) | 9.83 | < 0.01 | |
Rehabilitation | 23 | 17 (74%) | 5 (2-7) | 2.94 | NS | |
Family physicians
|
275
|
180 (65%) |
6 (4-10)
| |||
Traumatology | 56 | 17 (30%) | 6 (4-9) | 0.87 | NS | |
Tiotropium
| Pneumology | 15 | 14 (93%) | 1 (1-2) | 49.18 | < 0.01 |
Internal medicine | 30 | 14 (47%) | 2 (2-5) | 0.13 | NS | |
Family physicians
|
297
|
207 (70%) |
3 (2-4)
|