Table 2. Interrupted Time-Series Regression Analyses of Monthly Incidenta Prescriptions Dispensed (in Thousands) for Selected Drug Classes and Drugs, Before and During the COVID-19 Pandemicb.
| Drug class or drug | Intercept (95% CI) (April 2018) | Pre–COVID-19 pandemic (April 2018-March 2020) | Level change associated with COVID-19 pandemic (April 2020) | During COVID-19 pandemic (April 2020-March 2022) | Slope change associated with COVID-19 pandemic | ||||
|---|---|---|---|---|---|---|---|---|---|
| Slope (95% CI)c | P value | Level change (95% CI) | P value | Slope (95% CI)c | P value | Slope change (95% CI) | P value | ||
| Antidepressants | 1147.39 (1083.11 to 1211.68) | 6.15 (0.78 to 11.52) | .03d | −69.65 (−190.49 to 51.20) | .25 | 9.63 (3.86 to 5.39) | .002d | 3.48 (−4.41 to 11.36) | .38 |
| Sertraline | 202.64 (191.04 to 214.25) | 1.63 (0.69 to 2.58) | .001d | −13.43 (−36.14 to 9.28) | .24 | 1.87 (0.70 to 3.04) | .002d | 0.24 (−1.26 to 1.75) | .75 |
| Escitalopram | 172.89 (162.86 to 182.93) | 1.72 (0.87 to 2.56) | <.001d | −6.93 (−29.00 to 15.14) | .53 | 2.10 (0.89 to 3.32) | .001d | 0.39 (−1.09 to 1.86) | .60 |
| Benzodiazepines | 656.51 (634.32 to 678.69) | −2.37 (−4.08 to −0.67) | .008d | −30.31 (−72.50 to 11.87) | .16 | 0.33 (−2.06 to 2.71) | .79 | 2.70 (−0.24 to 5.64) | .07 |
| Alprazolam | 246.58 (235.41 to 257.74) | −0.67 (−1.78 to 0.43) | .23 | −11.69 (−32.02 to 8.65) | .25 | −0.38 (−1.10 to 0.35) | .30 | 0.30 (−1.02 to 1.61) | .65 |
| Lorazepam | 200.24 (193.79 to 206.69) | −0.37 (−0.93 to 0.18) | .19 | −4.81 (−16.20 to 6.58) | .40 | 0.07 (−0.48 to 0.61) | .80 | 0.44 (−0.33 to 1.21) | .26 |
| C-II stimulant | 200.88 (175.42 to 226.34) | 1.43 (−0.45 to 3.31) | .13 | −50.04 (−80.20 to −19.89) | .002d | 5.43 (4.16 to 6.71) | <.001d | 4.01 (1.59 to 6.42) | .002d |
| Amphetamine- dextroamphetamine |
100.14 (91.11 to 109.18) | 0.59 (−0.09 to 1.28) | .09 | −17.83 (−29.94 to −5.72) | .005d | 2.88 (2.39 to 3.37) | <.001d | 2.29 (1.42 to 3.15) | <.001d |
| Methylphenidate | 50.75 (41.31 to 60.19) | 0.50 (−0.18 to 1.17) | .14 | −16.62 (−26.06 to −7.18) | .001d | 1.44 (0.95 to 1.93) | <.001d | 0.94 (0.02 to 1.87) | .046d |
| Nonstimulant ADHD drugs | 36.15 (32.81 to 39.49) | 0.58 (0.32 to 0.83) | <.001d | −12.88 (−17.76 to −8.00) | <.001d | 1.70 (1.39 to 2.01) | <.001d | 1.12 (0.71 to 1.53) | <.001d |
| Atomoxetine | 20.57 (19.05 to 22.09) | 0.32 (0.20 to 0.44) | <.001d | −5.87 (−8.47 to −3.26) | <.001d | 1.11 (0.94 to 1.28) | <.001d | 0.79 (0.58 to 1.00) | <.001d |
| Guanfacine ER | 14.67 (12.57 to 16.77) | 0.23 (0.08 to 0.39) | .004d | −5.78 (−8.24 to −3.33) | <.001d | 0.41 (0.26 to 0.55) | <.001d | 0.17 (−0.06 to 0.40) | .14 |
| Buprenorphine MOUDe | 37.01 (35.49 to 38.53) | 0.14 (0.02 to 0.26) | .03d | −2.92 (−5.51 to −0.32) | .03d | 0.04 (−0.09 to 0.16) | .58 | −0.11 (−0.28 to 0.07) | .23 |
Abbreviations: ADHD, attention deficit hyperactivity disorder; C-II, Schedule II; ER, extended release; MOUD, medications for opioid use disorder.
Incident prescription is measured by new therapy start prescriptions, defined as prescriptions for a drug dispensed to patients with no prior prescription dispensed for a drug within the same drug class (eg, USC 64300 Antidepressants) in the previous 12 months.
Data Source: IQVIA National Prescription Audit. April 2018 to March 2022. Extracted March 2023. Limited to oral formulations; other formulations (eg, injection, implants) were not included. Nationally estimated data are provided for drug products labeled for mental health conditions, (eg, guanfacine ER products labeled for ADHD, buprenorphine-containing products labeled for OUD treatment). Prescriptions written by veterinary medicine, and prescriptions dispensed for unspecified patient age or sex were excluded. Except where specified, drugs include long-acting and short-acting formulations.
Slope coefficient is the estimated number of increases in New Therapy Start (IQVIA) prescription in thousands per month; we used Prais-Winsten regression with the Cochrane-Orcutt transformation and robust SEs to adjust for first-order serial autocorrelation. The COVID-19 outbreak in the US constitutes a national emergency, beginning March 1, 2020.
Indicates the results are significant at 95% level.
Buprenorphine-containing products and methadone are approved for MOUD; methadone was not included as methadone for OUD is only available from opioid treatment programs, and only methadone for analgesia is available through pharmacies. Only buprenorphine MOUD products (buprenorphine and buprenorphine/naloxone) labeled for the treatment of OUD were included in this drug class for our analyses.