Summary

A Clinical Practice Improvement study was conducted at six HMOs throughout the US to determine whether newer drugs are associated with lower health services utilization, including office visits, prescriptions, and hospitalizations.  Data were collected from 1,309 asthma patients at every encounter for one year, 1992.  Results show that greater use of newer asthma drugs was significantly associated with lower health care resource utilization, after controlling for severity of illness and other variables.

Primary Objective

Define newness of drug technology and show associations between two measures of newness and health services utilization for asthma patients.

Methods

1. Health care service utilization and changes in severity of illness at each office visit were assessed for 1,309 asthma patients from six HMOs during 1992.

2. The age of each drug product, derived by subtracting its FDA approval date from January 1, 1992, was used to construct two newness measures:  the average  age of all asthma drugs and separately all non-asthma drugs used during the year, and the percentages of a patient’s asthma drugs from each of four time intervals of asthma drug breakthroughs.

3. Service utilization variables included:  all PCP visits, total prescription costs, emergency department visits, and hospitalizations.

Results

1. Using either measure of drug newness, multivariate analyses showed an association between greater use of newer asthma drugs and lower overall drug costs and fewer PCP visits.
   

2. A trend was found between the greater use of newer asthma drugs and fewer hospitalizations and emergency department visits.
   

3. Newer non-asthma medications were associated with fewer emergency department visits.
   

Impact

After controlling for patient and site variables, greater use of newer asthma drugs was associated with significantly lower drug costs and PCP visits.  There was a trend of greater use of newer asthma drugs being associated with fewer hospitalizations and emergency department visits. (Annals of Pharmacotherapy, to appear)