Off-label Utilization of Antihypertensive Medications in Children
Yoon, Esther Y.; Dombkowski, Kevin J.; Rocchini, Albert; Lin, Jen-Jar; Davis, Matthew M.
Objective— To examine off-label utilization and costs of antihypertensive drugs in children using a national sample of prescription claims. Design— Cross-sectional study. Setting— 2002 Medstat MarketScan Database, a national sample of outpatient prescription claims of children ≥18 years old enrolled in private, employer-sponsored health plans. Main Outcome Measures— Off-label use of antihypertensive drugs by patient age and costs of antihypertensives calculated as mean cost per child per 30-day fill. Results— One-half of the index antihypertensive prescription claims were off-label, based on minimum age criteria. Boys were more likely (56%) than girls (46%) to be prescribed off-label antihypertensives (p<0.001). Children aged ≥12 years were more likely to be prescribed off-label antihypertensives (53%) compared with children aged ≥5 (46%) and 6–11 years (42%, p<0.001). Off-label use varied significantly by class of antihypertensive drugs (p<0.001). Overall, off-label antihypertensives were significantly more expensive than on-label antihypertensives. Conclusions— Despite availability of often less expensive on-label alternatives for the same class of antihypertensive drugs, off-label antihypertensive drugs were prescribed frequently in children. These findings underscore the potential clinical and economic implications of common off-label prescribing, for children, their parents, physicians and payers. Originally published Ambulatory Pediatrics, Vol. 7, No. 4, July 2007
Yoon, Esther Y., & Dombkowski, Kevin J., & Rocchini, Albert, & Lin, Jen-Jar, & Davis, Matthew M.. (July 2007). Off-label Utilization of Antihypertensive Medications in Children. Ambulatory Pediatrics, 7(4), 299- 303. Retrieved from http://hdl.handle.net/10342/3412
Yoon, Esther Y., and Dombkowski, Kevin J., and Rocchini, Albert, and Lin, Jen-Jar, and Davis, Matthew M.. "Off-label Utilization of Antihypertensive Medications in Children". Ambulatory Pediatrics. 7:4. (299-303), July 2007. August 21, 2018. http://hdl.handle.net/10342/3412.
Yoon, Esther Y. and Dombkowski, Kevin J. and Rocchini, Albert and Lin, Jen-Jar and Davis, Matthew M., "Off-label Utilization of Antihypertensive Medications in Children," Ambulatory Pediatrics 7, no. 4 (July 2007), http://hdl.handle.net/10342/3412 (accessed August 21, 2018).
Yoon, Esther Y., Dombkowski, Kevin J., Rocchini, Albert, Lin, Jen-Jar, Davis, Matthew M.. Off-label Utilization of Antihypertensive Medications in Children. Ambulatory Pediatrics. July 2007; 7(4): 299-303. http://hdl.handle.net/10342/3412. Accessed August 21, 2018.
East Carolina University