The fragility of bisphosphonate formulary policy
Author(s): ,
Shawn Bugden
Affiliations:
BScPharm MSc PharmD
,
Kevin J Friesen
Affiliations:
MSc
,
Jamie Falk
Affiliations:
BScPharm
Olasumbo Ojo
Affiliations:
BSc (Pharm) MSc (candidate)
Canadian Pharmacists Conference ePoster Library. Lane C. Jun 4, 2017; 174265
Cole Lane
Cole Lane
Login now to access Regular content available to all registered users.

You may also access this content "anytime, anywhere" with the Free MULTILEARNING App for iOS and Android
Abstract
Rate & Comment (0)

Objectives
To evaluate the impact of the change from pharmacist managed (Part 2 Exception Drug Status EDS) to physician controlled (Part 3 EDS) restricted access to bisphosphonates.

Methods
Utilization of oral bisphosphonates was assessed using data from the Manitoba Drug Program Information Network (DPIN) from 1998-2014. Incident use, overall utilization and medication costs were assessed before and after EDS coverage policy changes. Administrative data was used to assess the proportion of new users meeting one of three criteria (osteoporotic fractures, bone mineral density t-scores 2.5, or x-ray diagnosis of osteoporosis) using linked data from the Manitoba Population Research Data Repository.

Results
Alendronate and risedronate were the most common oral bisphosphonates used, comprising 68% and 20% of the new users (n = 61,260), respectively. Since restricting bisphosphonate coverage, the proportion of users meeting coverage criteria increased modestly from 29.5% [95% CI: 27.0%-32.0%] to 34.3% [95% CI: 31.6%-37.0%] (ANOVA F2, 12; P =0.034). During the pharmacist-managed coverage period (1998 to 2004) use increased with a mean number of incident users of 3,829/year [95% CI: 3,311-4,347] over that period. Since the implementation of a physician controlled system the number of incident users has fallen dramatically by 43% to 2,199/year [95% CI: 1,780-2,618] (P<0.0001). This decline in use occurred despite generic price reduction of more than 70% over the study period due to the release of generic equivalents.

Conclusion
Physician-managed formulary restriction to oral bisphosphonates appears to have been a substantial regressive barrier and has dramatically reduced bisphosphonate utilization. In light of lower generic cost and the modest difference in the proportion of users meeting EDS criteria, consideration should be given to returning to a pharmacy-managed approach that eliminates barriers but encourages appropriate utilization.

    This eLearning portal is powered by:
    This eLearning portal is powered by MULTIEPORTAL
Anonymous User Privacy Preferences

Strictly Necessary Cookies (Always Active)

MULTILEARNING platforms and tools hereinafter referred as “MLG SOFTWARE” are provided to you as pure educational platforms/services requiring cookies to operate. In the case of the MLG SOFTWARE, cookies are essential for the Platform to function properly for the provision of education. If these cookies are disabled, a large subset of the functionality provided by the Platform will either be unavailable or cease to work as expected. The MLG SOFTWARE do not capture non-essential activities such as menu items and listings you click on or pages viewed.


Performance Cookies

Performance cookies are used to analyse how visitors use a website in order to provide a better user experience.


Save Settings