Increased Moxifloxacin Utilization Associated with an Unrestricted Addition to a Drug Reimbursement Formulary: A Population-Based AnalysisReport as inadecuate




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Canadian Journal of Infectious Diseases and Medical Microbiology - Volume 25 2014, Issue 1, Pages 27-31

Original Article

Department of Medicine, Division of Infectious Disease, University of British Columbia, Vancouver General Hospital, Canada

Faculty of Pharmaceutical Sciences, University of British Columbia, Canada

British Columbia Centre for Disease Control, University of British Columbia, Vancouver, British Columbia, Canada

School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada



Copyright © 2014 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

OBJECTIVES:To determine whether utilization of moxifloxacin, a broad-spectrum fluoroquinolone antibiotic, has changed since its addition to the British Columbia provincial formulary in 2009 and to determine whether utilization was guideline concordant.

METHODS: BC PharmaNet prescriptions for moxifloxacin from 2001 to 2010 were anonymously linked to associated Medical Services Plan fee-for-service practitioner claims for indication-specific analysis. Prescribing trends for adults ≥18 years of age were described using defined daily dose DDD per 1000 person-years. Monthly utilization rates were fit to a linear regression model that controlled for seasonal variation to examine the effect of the formulary addition.

RESULTS: Utilization rose more than sevenfold throughout the study period, from 21.3 DDD per 1000 person-years in 2001 to 163.3 DDD per 1000 person-years in 2010. Although the formulary addition was not associated with an immediate increase in utilization 7.5% 95% CI −4.4% to 20.9%; P=0.226, it was associated with an overall increase in utilization of 2.1% 95% CI 1.3% to 3.0%; P<0.001 for every month after 2009. Overall, only 29% of moxifloxacin prescriptions could be linked to a diagnostic code that was considered to be guideline concordant. In more than one-half of moxifloxacin prescriptions, the patient had not used another antibiotic in the previous 90 days. Among moxifloxacin prescriptions in which another antibiotic had been used in the previous 90 days, 41.5% were prescriptions for an alternative fluoroquinolone.

CONCLUSIONS: The formulary addition was associated with a sustained increase in moxifloxacin utilization over time. Moxifloxacin is often prescribed to patients for indications that are not guideline concordant or to patients who have not previously received first-line antibiotics.





Author: Alissa Jade Wright, Fawziah Marra, Mei Chong, Catharine Chambers, William R Bowie, and David M Patrick

Source: https://www.hindawi.com/



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