intervention reduces fluoxetine use, costs in managed care

PharmacoEconomics & Outcomes News 352 - 2 Mar 2002

Intervention reduces fluoxetineuse, costs in managed care

A combination of academic detailing and physicianprescribing profiles can reduce the use of the costlyselective serotonin reuptake inhibitor (SSRI) fluoxetine,and increase the use of other less costly SSRIs, accordingto US-based researchers.1

They retrospectively analysed pharmacy claims datafrom a staff-model managed-care organisation in Texas,US, for the period January 1997 to December 2000, todetermine the effect of academic detailing and physicianprescribing profiles on the use and cost of fluoxetine andother SSRIs. Physician prescribing profiles wereimplemented in November 1998 and distributedquarterly thereafter, supported by academic detailing atmost health plan clinics.

Results showed that days of fluoxetine therapydeclined from 0.24 days per member per month(PMPM) in 1997 to 0.177 days PMPM in 2000,representing a 26% drop. This compared with a 43% risein the use of other SSRIs, from 0.535 to 0.763 days oftherapy PMPM, respectively, over the same period.Fluoxetine expenditures for the health plan decreasedfrom $US1.43 million in 1998 to $US1.09 million in2000, while SSRI prescription drug costs increased from$US2.68 million in 1998 to $US3.33 million in 2000.Net savings for the health plan with the combinedintervention were estimated at $US206 644 over 2years, or $US0.61 per member per year.

In an accompanying editorial, Dr Frederic Curtissnotes that these results ‘only suggest and do not provethat intervention with physicians . . . may influence theaverage cost per day of drug therapy’.2 However, he addsthat some evidence was provided to indicate that theintervention ‘was associated with a favourable costoutcome’, and that the study ‘raises the bar’ for reportsof managed-care interventions.1. Yokoyama KK, et al. Effect of physician profiles and academic detailing on cost

and utilization of selective serotonin reuptake inhibitors. Journal of ManagedCare Pharmacy 8: 23-31, Jan-Feb 2002.

2. Curtiss FR. Searching for drug benefit benchmarks - cost per day of therapy.Journal of Managed Care Pharmacy 8: 54-55, Jan-Feb 2002.

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PharmacoEconomics & Outcomes News 2 Mar 2002 No. 3521173-5503/10/0352-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved