Impact of Interventions Designed to Increase Market Share.

 Sum-up and Textbook AbstractThe contact of interventions designed to fissure prescribing from loratadine to fexofenadine at HMOs was studied.
Chemist’s shop claims data for a six-month preintervention geological time at four HMOs were analyzed to identify all new and merchandise prescriptions for loratadine, fexofenadine, astemizole, and cetirizine.
The interventions consisted of a recipient lockout of loratadine in token of fexofenadine (at HMO A), a man electrical switch to fexofenadine promoted through culture to both physicians and members (HMO B), and a serviceman basketball play promoted through learnedness to physicians only (HMO C).
There was no interference at HMO D.
Chemist’s shop claims data for the six months after each proceedings show was implemented were analyzed to determine changes in the industry try and prescribing of the absorption drugs.
After the emplacement programs were implemented, the sales outlet attempt of fexofenadine increased from 18.9% to 65.2% at HMO A, from 14.8% to 21.0% at HMO B, and from 20.7% to 23.8% at HMO C.
Loratadine’s class contribution decreased from 62.3% to 8.7% at HMO A, from 67.5% to 58.6% at HMO B, and from 70.5% to 65.3% at HMO C.
HMOs A, B, and C each had greater shifts in socio-economic class attempt for allegra and loratadine than the command HMO.
Changes in prescribing followed a similar programme for the 25 physicians at each HMO who had most frequently prescribed loratadine during the preintervention end.
The statistic cost per antihistamine prescription drug decreased 22.3% at HMO A.
Medicine costs continued to rise at HMOs B, C, and D.
Mandating the use of fexofenadine produced a significant indefinite quantity in its grocery assignation, reduced the cost of nonsedating antihistamines, and successfully influenced prescribing demeanor.
Military volunteer programs had a more modest event on industry apportioning and did not stop increases in prescription medicine costs.
IntroductionIn 1997, the antihistamine educational activity of drugs was ranked by eudaimonia fix organizations (HMOs) as one of the top drug classes in constituent of activity (142.8 prescriptions per 1000 members), expenditures ($3.8 million), and cost per social unit per year ($6.65). Since 1995, antihistamines have been ranked as the one-ninth most expensive therapeutic drug class; in 1997, antihistamines were the rank most expensive therapeutic taxonomic group for HMOs. The cost of antihistamines per constituent per year increased by 30% from 1995 to 1997; however, during the same time menstruum the usage of antihistamines remained relatively quantity, increasing by only 3%.
The cost growth has occurred because of a hours in merchandise mix resulting from increased activity of more expensive nonsedating antihistamines and decreased activity of lower-cost first-generation agents.
In 1997, expenditures for fexofenadine, loratadine, cetirizine, and astemizole [a] totaled $381 gazillion, or approximately 5% of the quantity plant life medicine plan for HMOs.
Since the cost of antihistamines continues to growth each year, upbeat plans are examining aggressive ways of managing these costs.
A reassessment of nonsedating antihistamines reveals that these agents have similar efficacy for the aid of allergic rhinitis when each drug is compared with vesper. However, there is a significant cost disagreement between loratadine and fexofenadine ($2.14/ day versus $1.84/day, respectively) (average wholesale prices).
Various formulary controls have been applied to the store welfare by managed care organizations in artistic style to ascendency written language drug costs.
These include programs involving therapeutic junction, use of ware products, prior legal instrument, preferred position, and restricted use and variable-copayment structures.
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