Table 1.
Utilization and Expenditures for COX-2 Inhibitors, NSAIDs, Other Pain Relievers, and Gastroprotectants (PAR Implemented July 1, 2002)
| Overall | 2001Q3 | 2001Q4 | 2002Q1 | 2002Q2 | 2002Q3 | 2002Q4 | 2003Q1 | 2003Q2 |
|---|---|---|---|---|---|---|---|---|
| COX-2 inhibitors* | ||||||||
| Total expenditures | $1,372,643 | $1,488,836 | $1,565,460 | $1,678,913 | $792,227 | $842,935 | $800,534 | $790,118 |
| Total Rx claims | 19,314 | 19,875 | 19,736 | 20,382 | 9,794 | 10,200 | 9,499 | 9,232 |
| NSAIDs† | ||||||||
| Total expenditures | $364,148 | $343,814 | $321,809 | $352,922 | $516,424 | $557,984 | $550,500 | $572,687 |
| Total Rx claims | 18,708 | 19,546 | 19,864 | 19,282 | 25,129 | 25,677 | 24,327 | 23,207 |
| Pain relievers (other)‡ | ||||||||
| Total expenditures | $227,462 | $255,382 | $208,022 | $213,766 | $307,548 | $259,554 | $234,132 | $238,938 |
| Total Rx claims | 6,035 | 6,051 | 5,209 | 5,257 | 6,778 | 6,497 | 6,054 | 5,880 |
| Per/recipient/month data§ | ||||||||
| COX-2 inhibitors* | ||||||||
| Expenditure/recipient/month§ | $91.66 | $94.50 | $89.46 | $93.63 | 0 | 0 | 0 | 0 |
| NSAIDs† | ||||||||
| Expenditure/recipient/month§ | 0 | 0 | 0 | 0 | $23.33 | $24.19 | $22.32 | $22.12 |
| Pain relievers (other)‡ | ||||||||
| Expenditure/recipient/month§ | 0 | 0 | 0 | 0 | $2.92 | $4.28 | $7.46 | $7.80 |
| Gastroprotectants§ | ||||||||
| Expenditures/recipient/month | ||||||||
| PPIs | $20.99 | $21.70 | $19.76 | $18.98 | $44.88 | $36.85 | $7.04 | $10.56 |
| H2RAs | $1.12 | $1.09 | $1.18 | $.99 | $2.27 | $4.22 | $8.39 | $6.14 |
| Gastroprotectant (other) | $0.16 | $0.14 | $0.15 | $0.20 | $0.42 | $0.51 | $0.59 | $0.59 |
| OTC antacids | $0.13 | $0.11 | $0.12 | $0.09 | $0.27 | $0.26 | $0.26 | $0.24 |
| Total gastroprotectants | $22.40 | $23.04 | $21.21 | 20.26 | $47.84 | $41.84 | $16.28 | $17.53 |
| Claims/recipient/month | ||||||||
| PPIs | 0.17 | 0.18 | 0.15 | 0.14 | 0.31 | 0.29 | 0.06 | 0.08 |
| H2RAs | 0.06 | 0.06 | 0.05 | 0.04 | 0.12 | 0.20 | 0.37 | 0.33 |
| Gastroprotectants (other) | 0.01 | 0.01 | 0.01 | 0.01 | 0.01 | 0.01 | 0.01 | 0.01 |
| OTC antacids | 0.02 | 0.02 | 0.02 | 0.02 | 0.05 | 0.06 | 0.05 | 0.05 |
| Total expenditure¶ | ||||||||
| Expenditure/recipient/month∥ | $114.06 | $117.54 | $110.67 | $113.89 | $74.09 | $70.31 | $46.06 | $47.45 |
COX-2 inhibitors (Bextra®, Celebrex®, Vioxx®).
NSAIDs (diclofenac sodium, diclofenac potassium, diclofenac/misoprostol, etodolac, fenoprofen, flurbiprofen, ibuprofen, indomethacin, ketoprofen, ketorolac, meclofenamate, mefenamic acid, meloxicam, nabumetone, naproxen, oxaprozin, piroxicam, sulindac, tolmetin).
Other pain relievers includes narcotic analgesics (e.g., Percocet®), salycylate analgesics (e.g., aspirin), nonsalicylate, nonnarcotic analgesics (e.g., acetaminophen), antimigraine drugs (e.g., Imitrex®), other medications indicated for rheumatoid arthritis (Enbrel®, Humira®).
For those recipients who switched from a COX-2 inhibitor to an NSAID, or other pain reliever as a consequence of the PAR.
Total expenditure=Expenditure for COX-2 Inhibitor or nonselective NSAID or other pain reliever+gastroprotectant therapy.
Mean comparisons against 2002Q2 for the last four quarters of the study period statistically significant at p<.05.
PPIs, proton pump inhibitors (e.g., Prilosec®); H2RAs, histamine-2 receptor antagonists (e.g., ranitidine); OTC antacids, over-the-counter antacids (e.g., Maalox®).