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SELECTED HSRN ANNOTATED BIBLIOGRAPHY, 2003-2011
(Updated April 2011).

The IMS Health Services Research Network is comprised of academic researchers who are conducting empirically rigorous, policy-relevant studies to improve the quality and cost-effectiveness of health care in the United States. The network includes members from a variety of complementary disciplines including pharmacy, medicine, law, economics, business, and public policy. This annotated bibliography reflects more than 90 publications by HSRN members in the peer-reviewed literature during recent years using IMS Health's data assets. 1. Jackevicius CA, Tu JV, Ross JS, Ko DT, Carreon D, Krumholz HM. Use of Fibrates in the United States http://www.ncbi.nlm.nih.gov/pubmed/21427374 The authors used the National Prescription Audit™ (NPA) and the CompuScript™ Audit to compare the use of fibrates and evaluate the economic implications of brand vs generic use in the United States and Canada from January 2002 through December 2009. They found that use of fibrates increased steadily in the United States, though not in Canada, despite evidence raising questions regarding the relative benefits of fibrates compared with statins. Increases in fibrate use were driven primarily by branded fenofibrate. 2. Doloresco F, Fominaya C, Schumock GT, Vermeulen LC, Matusiak L, Hunkler RJ, Shah ND, Hoffman JM . Projecting Future Drug Expenditures--2011. Am J Health Syst Pharm. 2011;68:e1-e12. http://www.ajhp.org/site/Drugexpenditures_2011.pdf The authors used National Sales Perspectives™ (NSP) and National Prescription Audit™ (NPA) to analyze drug expenditure trends in 2009 and 2010, to project drug expenditures for 2011, and to examine factors likely to influence drug expenditures. Taking into account health care reform, past trends, and other related factors, the authors predicted a 3-5% increase in drug expenditures in outpatient settings, a 4-6% increase in expenditures for clinic administered drugs, and a 1-3% increase in hospital drug expenditures. 3. Gaglio PJ, Moss N, McGaw C, Reinus J. Direct-Acting Antiviral Therapy for Hepatitis C: Attitudes Regarding Future Use. Dig Dis Sci. 2011 Feb 19. [Epub ahead of print] http://www.ncbi.nlm.nih.gov/pubmed/21336604 The authors used IMS Health Incorporated Prescriber Profile™ data to establish the number of prescriptions written to treat Hepatitis C, as well as the fraction of these written by gastroenterologists or hepatologists (55%), internal medicine physicians (11%), and nurse practitioners (8%). They used these data in a survey evaluating knowledge and attitudes towards direct-acting antiviral therapies and other treatments of Hepatitis C. 4. Alexander GC, Gallagher SA, Mascola A, Moloney RM, Stafford RS. Increasing Off-Label Use of Antipsychotic Medications in the United States, 1995-2008. Pharmacoepidemiol Drug Saf. 2011;20:177-184 http://www.ncbi.nlm.nih.gov/pubmed/21218418 The authors used the IMS National Disease and Therapeutic Index™ (NDTI) to quantify patterns of typical and atypical antipsychotic use. They document the replacement of typical with atypical agents, substantial increases in atypical use from 2000 through 2007, and an increasing use of atypical therapies for settings with uncertain scientific support. IMS Health
5. Hersh AL, Stafford RS. Antiviral Prescribing by Office-Based Physicians During the 2009 H1N1 Pandemic. Ann Intern Med. 2011;154:74-6. http://www.ncbi.nlm.nih.gov/pubmed/21200049 The authors used the IMS National Disease and Therapeutic Index™ (NDTI) to estimate the number of monthly visits in which influenza was diagnosed and the proportion of visits in which an antiviral was prescribed for influenza between October 2006 and March 2010. The authors found a surge of influenza visits and antiviral prescribing attributable to the 2009 H1N1 influenza pandemic from October to December 2009, though there was no change in the overall propensity to prescribe antivirals in ambulatory settings compared with previous years. 6. Tsai SA, Stefanick ML, Stafford RS. Trends in Menopausal Hormone Therapy Use of US Office-Based Physicians, 2000-2009. Menopause. April 2011 - Volume 18 - Issue 4 - pp 385-392 http://www.ncbi.nlm.nih.gov/pubmed/21127439 The authors used the IMS National Disease and Therapeutic Index™ (NDTI) to describe the number of physician visits in which menopausal hormone therapy was mentioned from 2001 to 2009. Overall, the authors saw a decline in use and an increase of lower dose and vaginal products, reflective of clinical recommendations. 7. Hicks LA, Suda KJ, Roberts RM, Hunkler RJ, Taylor TH, Danziger LH. Data Reveal Wide Geographic Variability in Antimicrobial Use in the United States, 2009. Poster, Infectious Disease Society of America, October, 2010. http://idsa.confex.com/idsa/2010/webprogram/Paper3571.html and The authors used National Sales Perspective™ (NSP) to document that roughly two-thirds of U.S. sales of antibiotics in 2009 were distributed via non-acute channels. Additional observations were made through the use of Xponent™: A group of Southern states exhibited inordinately high prescribing rates of all classes of antibiotics; and states in which CDC-funded appropriate antibiotic use campaigns were in place exhibited below-average prescribing rates. 8. Hayes BL, Curtis JR, Laster A, Saag K, Tanner SB, Liu C, Womack C, Johnson KC, Fazila Khaliq, Carbone LD. Osteoporosis Care in the United States After Declines in Reimbursements for DXA. Journal of Clinical Densitometry. 2010;13:352-360. http://www.ncbi.nlm.nih.gov/pubmed/21029972 The authors used the IMS National Prescription Audit™ to quantify the number of prescriptions for osteoporosis drugs, stratified by prescriber specialty, from 2005 to 2008. The authors found an increase in retail prescriptions for FDA approved osteoporosis drugs during 2007 to 2008 compared with 2005 to 2006. 9. Yin HS, Wolf MS, Dreyer BP, Sanders LM, Parker RM. Evaluation of Consistency in Dosing Directions and Measuring Devices for Pediatric Nonprescription Liquid Medications. JAMA. 2010;304:2595-602. http://www.ncbi.nlm.nih.gov/pubmed/21119074 The authors used the IMS Health Medicine Cabinet™ database to determine the top selling nonprescription products and to assess the clarity and consistency of dosing directions and measuring dose devices at the time the FDA issued guidelines concerning dosage labels. They found top-selling therapies had highly variable and inconsistent measuring devices and instructions 10. Shah ND, Montori VM, Krumholz HM, Tu K, Alexander GC, Jackevicius CA. Responding to an FDA warning--Geographic Variation in the Use of Rosiglitazone. N Engl J Med. 2010;363:2081-4. http://www.ncbi.nlm.nih.gov/pubmed/21083379 The authors used the National Prescription Audit™ and the Xponent™ database to analyze the effect of the rosiglitazone warning on regional prescribing variations. The authors observed a 70% decrease in rosiglitazone following an FDA warning, publication of a meta-analysis and associated media coverage. Additionally, they observed great geographic variation in rosiglitazone use between 2005 and 2009. 11. Hoffman JM, Doloresco F, Vermeulen LC, Shah ND, Matusiak L, Hunkler RJ, Schumock GT. Projecting Future Drug Expenditures--2010. Am J Health Syst Pharm. 2010;67:919-28. http://www.ncbi.nlm.nih.gov/pubmed/20484216
The authors used National Sales Perspectives™ (NSP) and National Prescription Audit™ (NPA) to
analyze drug expenditure trends in 2008 and 2009, to project drug expenditures for 2010, and to examine
factors likely to influence drug expenditures. Taking into account health care reform, past trends, and other
related factors, the authors predicted a 3-5% increase in drug expenditures in outpatient settings, 6-8%
increase in expenditures for clinic administered drugs, and a 2-4% increase in hospital drug expenditures.

12. Taub AAL, Kolotilin A, Gibbons RS, Berndt ER. The Diversity of Concentrated Prescribing Behavior: An Application to Antipsychotics. NBER Working Paper No. 16823. Issued in February 2011 http://www.nber.org/papers/w16823 The authors use IMS Health Xponent™ data to evaluate physicians’ use of atypical antipsychotics. Building on prior work, they construct a model of physician learning and then empirically evaluate several hypotheses. While prescribing behavior was generally quite concentrated, prescribers with greater volumes, psychiatric training, male prescribers, and older prescribers tended to have less concentrated prescribing patterns. 13. Martin-Doyle W, Essebag V, Zimetbaum P, Reynolds MR. Trends in US Hospitalization Rates and Rhythm Control Therapies Following Publication of the AFFIRM and RACE Trials. J Cardiovasc Electrophysiol. 2010 Nov 18. [Epub ahead of print] http://www.ncbi.nlm.nih.gov/pubmed/21087329 The authors used the IMS National Prescription Audit™ to examine the impact of trials comparing rate vs. rhythm control for atrial fibrillation on the use of rhythm control therapies and hospitalizations in the United States. Use of rhythm control therapies declined significantly after publication of the AFFIRM and RACE trials until 2005, when trends reversed and an increase in the use of catheter ablation for atrial fibrillation was also observed. 14. Mehta S, Chen H, Johnson ML, Aparasu RR. Risk of Falls and Fractures in Older Adults Using Antipsychotic Agents: a Propensity-Matched Retrospective Cohort Study. Drugs Aging. 2010;27:815-29. http://www.ncbi.nlm.nih.gov/pubmed/20883062 The authors used the IMS LifeLinkTM Health Plan Claims Database to match a cohort of adults over the age of 50 using atypical to a similar cohort using typical antipsychotic agents. The authors found no statistically significant difference between the two cohorts with respect to the likelihood of falls or fractures. 15. Banarjee D, Stafford RS. Lack of Improvement in Outpatient Management of Congestive Heart Failure in the United States. Arch Intern Med. 2010;170:1399-1400. http://www.ncbi.nlm.nih.gov/pubmed/20696970 The authors used the IMS National Disease and Therapeutic Index™ (NDTI) to evaluate whether patterns of congestive heart failure medications have adopted evidence-based therapies. They found some recommended therapies to begin to decline in the mid-2000s while others reached a plateau in this same time frame. 16. Dorsey ER, Rabbani A, Gallagher SA, Conti RM, Alexander GC. Impact of FDA Black Box Advisory on Antipsychotic Medication Use. Archives of Internal Medicine. 2010;170:96-103. http://www.ncbi.nlm.nih.gov/pubmed/20065205 The authors used the National Disease and Therapeutic Index™ (NDTI) to evaluate the impact of the 2005 FDA black box warning regarding the risks of atypical anti-psychotic use among elderly patients with dementia on the use of these agents. They found that the FDA advisory was associated with a 2% decrease in the use of atypical antipsychotics overall and a 19% decrease in use among elderly patients with dementia. 17. Stafford RS, Bartholomew LK, Cushman WC, Cutler JA, Davis BR, Dawson G, Einhorn PT, Furberg CD, Piller LB, Pressel SL, Whelton PK. Impact of the ALLHAT/JNC7 Dissemination Project on Prescribing of Thiazide-Type Diuretic Use Arch Intern Med. 2010;170:851-858. http://www.ncbi.nlm.nih.gov/pubmed/14709576 The authors used the National Disease and Therapeutic Index™ (NDTI) and National Prescription Audit™ (NPA) to describe the impact of the ALLHAT/JNC7 Dissemination project on prescribing of thiazide-type diuretics. They found an association between ALLHAT/JNC7 academic detailing activities and increased prescribing of thiazides, with increases highest in counties where academic detailing activity was also highest. However they found no increase in national thiazide-type diuretic use between 2004-2008. 18. Cohen A, Rabbani A, Shah N, Alexander GC. Changes in Glitazone Use Among Office-based Physicians in the U.S.,2003-2009. Diabetes Care. 2010;33:823-825 http://www.ncbi.nlm.nih.gov/pubmed/20103549 The authors used IMS Health’s National Disease and Therapeutic Index™ data to describe changes in rosglitazone and pioglitazone use. They found an increase in glitazone use from 2003 to 2005 followed by a decrease of 16% in rosiglitazone and an increase of 14% in pioglitazone from 2005 to January 2007. Accompanying the FDA advisory there was a sharp decline in rosiglitazone from February 2007 to May 2008 while pioglitazone use simultaneously remained steady. 19. Outterson K. The Legal Ecology of Resistance: The Role of Antibiotic Resistance in Pharmaceutical Innovation. Cardozo Law Review. 2010;31:613-678 http://www.cardozolawreview.com/content/31-3/OUTTERSON.31-3.pdf The author used MIDAS™ data to supplement an analysis of methods to approach three important policy questions concerning antibiotic resistance: (1) the tension between production of new antibiotics and conservation of existing drugs, (2) the relationship between resistance and innovation, and (3) the policy levers employed in the battle against antibiotic resistance. 20. Mehta S, Johnson ML, Chen H, Aparasu RR. Risk of Cerebrovascular Adverse Events in Older Adults Using Antipsychotic Agents: A Propensity-Matched Retrospective Cohort Study. J Clin Psychiatry. 2010;71:689-698. http://www.ncbi.nlm.nih.gov/pubmed/20573328 The authors use the IMS LifeLink™ Health Plan Claims Database to compare the risk of cerebrovascular adverse events with second-generation antipsychotic users versus those taking first-generation antipsychotics in community-dwelling older adults. Using regression analysis, the authors found no significant association between the use of the first-versus second-generation antipsychotics and a risk of cerebrovascular adverse events. 21. Trusheim MR, Aitken ML, Berndt ER. Characterizing Markets for Biopharmaceutical Innovations: Do Biologics Differ from Small Molecules? Cambridge, MA: National Bureau of Economic Research, Working Paper 16014, May 2010. Forthcoming, Forum for Health Economics & Policy, 2010. http://www.nber.org/papers/w16014.pdf The authors generated a new database (TABITHA) using information from IMS Health MIDAS™ database, the FDA, the WHO, and the U.S. Bureau of Economic Analysis to examine clinical and commercial characteristics of biologic and small molecule products. They conclude that although therapeutic class composition is a significant determinant of clinical and commercial characteristics, the market dynamics of biologics differ substantially from those of small molecules. 22. Nyweide DJ, William BW, Gottlieb DJ, Casalino LP, Fisher ES. Relationship of Primary Care Physicians' Patient Caseload With Measurement of Quality and Cost Performance. JAMA. 2009;302:2440-2450 http://www.ncbi.nlm.nih.gov/pubmed/19996399 The authors used the Healthcare Organization Services database maintained by IMS Health to determine whether primary care physicians in the same physician practice collectively see enough Medicare patients annually to detect meaningful differences between practices in ambulatory quality and cost measures. They concluded that relatively few primary care physician practices are large enough to reliably measure 10% relative differences in common measurements of quality and cost performance among fee-for-service Medicare patients. 23. Dorsey ER, Thompson JP, Dayoub EJ, George B, Saubermann LA, Holloway RG. Selegiline Shortage: Causes and Costs of a Generic Drug Shortage. Neurology. 2009;73:213-7. http://www.ncbi.nlm.nih.gov/pubmed/19620609 The authors used National Prescription Audit™ (NPA) to evaluate prescription trends of generic selegiline and to quantify the economic impact of any drug substitution resulting from shortages of the generic drug that occurred in September 2007. They found that the societal cost of substituting generic selegiline with branded capsules was $75,000 over the first 4 months of the shortage. 24. Dorn SD, Farley JF, Hansen RA, Shah ND, Sandler RS. Direct-to-Consumer and Physician Promotion of Tegaserod Correlated With Physician Visits, Diagnoses, and Prescriptions. Gastroenterology. 2009; 137:518-524. http://www.ncbi.nlm.nih.gov/pubmed/19445943 The authors used an Integrated Promotional Services™ database, the National Ambulatory/Hospital Medical Care Surveys (1997-2005), and IMS Health’s National Prescription Audit™ to analyze the impact of direct-to-consumer advertising (DTCA) and physician promotion of tegaserod on the number of office visits for abdominal pain, constipation, and bloating; diagnoses of irritable bowel syndrome; and tegaserod prescriptions. They found a significant relationship between physician promotion, though not DTCA, and tegaserod prescribing. 25. Lichtenberg FR. Have Newer Cardiovascular Drugs Reduced Hospitalization? Evidence From Longitudinal Country-Level Data on 20 OECD Countries, 1995-2003. Health Economics. 2009;18:519-534. http://www.ncbi.nlm.nih.gov/pubmed/18634121 The author used MIDAS™ to examine the effect of changes in the vintage distribution of cardiovascular system drugs on hospitalization and mortality. The estimates indicate that the use of newer cardiovascular drugs has reduced the average length of hospital stay and the age-adjusted cardiovascular mortality rate, but not the number of potential years of life lost due to cardiovascular disease before age 70 per 100,000 population. 26. Long MD, Porter CQ, Sandler RS, Kappelman MD. Suboptimal Rates of Cervical Testing Among Women with Inflammatory Bowel Disease. Clinical Gastroenterology and Hepatology. 2009;7:549-53. http://www.ncbi.nlm.nih.gov/pubmed/18996498 The authors used IMS LifeLinkTM: Health Plan Claims data to determine cervical testing rates among women with inflammatory bowel disease (IBD) on immunosuppressant medications, and to identify risk factors associated with low screening rates. They found systematic under-screening of women with IBD. 27. Hoffman JM, Shah ND, Vermeulen LC, Doloresco F, Martin PK, Blake S, et al. Projecting Future Drug Expenditures – 2009. American Journal of Health System Pharmacy. 2009;66:237-57. http://www.ncbi.nlm.nih.gov/pubmed/19179637 The authors used National Sales Perspectives™ (NSP) and National Prescription Audit™ (NPA) to analyze drug expenditure trends in 2007 and 2008, project drug expenditures for 2009, and examine factors likely to influence drug expenditures. 28. Duggan M, Morton FS. The Effect of Medicare Part D on Pharmaceutical Prices and Utilization. NBER http://www.nber.org/papers/w13917 Duggan and colleagues use IMS data to investigate the effect of Medicare Part D on the price and utilization of branded pharmaceutical treatments from 2001 to 2006. The authors saw a total sales increase from $162.2 billion in 2001 to $223.9 billion in 2006. The authors concluded that Medicare Part D lowered pharmaceutical prices by approximately 13 percent for beneficiaries of the program. 29. Walton SM, Schumock GT, Lee KV, Alexander GC, Meltzer D, Stafford RS. Prioritizing Future Research on Off-Label Prescribing: Results of a Quantitative Evaluation. Pharmacotherapy. 2008;28:1443-1452. http://www.ncbi.nlm.nih.gov/pubmed/19025425 The authors used the National Prescription Audit™ (NPA) and Integrated Promotional Services™ (IPS) to develop a prioritized list of individual drugs for which future research regarding off-label uses is warranted. They identified a high volume of off-label prescribing in the absence of good evidence for a substantial number of drugs, particularly antidepressants, antipsychotics, and anxiolytic-sedatives. 30. Philipson T, Berndt ER, Gottschalk AHB, Sun E. Cost-Benefit Analysis of the FDA: The Case of the Prescription Drug User Fee Acts. Journal of Public Economics. 2008;92:1306-1325. http://web.mit.edu/cbi/publications/JPubE_Philipson.pdf The authors used National Sales Perspectives™ (NSP) data to estimate the welfare effects of the Prescription Drug User Fee Acts (PDUFA). They found that PDUFA raised the private surplus of producers by about $7 to $11 billion and raised consumer welfare between $7 to $20 billion; thus the combined social surplus was raised by $14 to $31 billion, which is the equivalent of 140,000 to 310,000 life years. 31. Huskamp HA, Donohue JM, Koss C, Berndt ER, Frank RG. Generic Entry, Reformulations, and Promotion of SSRIs. PharmacoEconomics. 2008;26:603-16. http://www.ncbi.nlm.nih.gov/pubmed/18563951 The authors used Integrated Promotional Services™ (IPS) to examine the relationships among promotional expenditures, generic entry, reformulation entry and new indication approval. They found that the introduction of new product formulations appears to be a common strategy for extending market exclusivity for medications facing impending generic entry. Manufacturers who introduced a reformulation before generic entry shifted most promotion dollars from the original brand to the reformulation long before generic entry, and in some cases appeared to target a particular promotion type for a given indication. 32. Mindel JS. Amiodarone and Optic Neuropathy. American Heart Journal. 2008;156:411-13. http://www.ncbi.nlm.nih.gov/pubmed/18760119 The author used IMS LifeLinkTM: Health Plan Claims data and National Prescription Audit™ (NPA) in addition to FDA records and a prospective, double-maked randomized trial to show that the existing literature and evidence estimates of the incidence of amiodarone-associated optic neuropathy are too high. They are skeptical that amiodarone produces a toxic neuropathy or that it has a preventative effect on idiopathic anterior ischemic optic neuropathy and do not recommend that physicians consider it as a factor in deciding whether a patient will benefit from its use. 33. Aitken ML, Berndt ER, Cutler DM. Prescription Drug Spending Trends in the US: Looking Beyond the Turning Point. Health Affairs – Web Exclusive. 2009;28:W151-60. http://www.ncbi.nlm.nih.gov/pubmed/19088102 The authors used National Sales Perspectives™ (NSP) and National Prescription Audit™ (NPA) to document trends and identify underlying components: declines in the role of blockbuster drugs, increased importance of biologics and vaccines relative to traditional pharmaceuticals, and a changing medication mix away from those prescribed principally by primary care physicians toward those mostly prescribed by specialists. 34. Kappelman MD, Rifas-Shiman SL, Porter CQ, et. al. Direct Health Care Costs of Treatment of Crohn's Disease and Ulcerative Colitis in U.S. Children and Adults. Gastroenterology. 2008;135:1907-13. http://www.ncbi.nlm.nih.gov/pubmed/18854185 The authors used IMS LifeLinkTM: Health Plan Claims data to estimate the direct costs of Crohn's disease (CD) and ulcerative colitis (UC) in the US, to describe the distribution of costs among inpatient, outpatient, and pharmaceutical services, and to identify sociodemographic factors influencing these costs. They analyze claims from 87 health plans in 33 states between 2003 and 2004. They estimate that mean annual costs for CD and UC were $8265 and $5066, respectively, and costs were significantly higher for children younger than 20 years of age. 35. Alexander GC, Sehgal NL, Moloney RM, Stafford RS. National Trends in Treatment of Type 2 Diabetes Mellitus, 1994-2007. Archives of Internal Medicine. 2008;168:2088-2094. http://www.ncbi.nlm.nih.gov/pubmed/18955637 The authors used the National Disease and Therapeutic Index™ (NDTI), National Prescription Audit™ (NPA), and National Sales Perspective™ (NSP) to analyze medications prescribed between 1994-2007 for Type 2 diabetes. They also estimate total costs of diabetes treatments between 2001 and 2008. They conclude that increasingly complex and costly diabetes treatments are being applied to a growing population. 36. Gibbons RD, Brown CH, Hr K, et al. Early Evidence on the Effects of Regulators’ Suicidality Warnings on SSRI Prescriptions and Suicide in Children and Adolescents. American Journal of Psychiatry. 2007;164:1356-63. http://www.ncbi.nlm.nih.gov/pubmed/17728420 The authors used the National Prescription Audit™ (NPA) to assess whether regulatory warnings discouraged use of antidepressants in children and adolescents and whether they led to increases in suicide rates as a result of untreated depression. They found that SSRI prescriptions for youths decreased by approximately 22% in both the US and the Netherlands after the warnings were issued. In the Netherlands, the youth suicide rate increased by 49% between 2003 and 2005 and in the US, youth suicide rates increased by 14% between 2003 and 2004. 37. Valuck RJ, Libby AM, Orton HD, Morrato EH, Allen R, Baldessarini RJ. Spillover Effects on Treatment of Adult Depression in Primary Care After FDA Advisory on Risk of Pediatric Suicidality with SSRIs. American Journal of Psychiatry. 2007;164:1198-205. http://www.ncbi.nlm.nih.gov/pubmed/17671282 The authors used IMS LifeLinkTM: Health Plan Claims data to examine the effects of the FDA public health advisory regarding the risk of suicidality in pediatric patients taking selective SSRIs on the treatment of adult depression in the community. They found that the advisory had a significant spillover effect into treatment of adults with depression, including a lower rate of diagnosed depression, decreased percentage of adults with new depressive episodes, and decreased percentage of depressed adults who did not receive an antidepressant. 38. Lee PP, Levin LA, Walt JG, Chiang TH, Doyle JJ, Stern LS, Dolgitser M. The Impact of Glaucoma Coding in a Large Claims Database. American Journal of Ophthalmology. 2007;143:867-70. http://www.ncbi.nlm.nih.gov/pubmed/17452173 The authors used IMS LifeLinkTM: Health Plan Claims data to develop methods for investigating adherence to glaucoma medications based on analyses of patients receiving glaucoma medication between 1999 and 2005, chart review, and patient and physician interviews. They found that large pharmacy databases are vulnerable to errors (e.g., poor adherence, misidentification of newly treated patients), that adherence to glaucoma treatments is poor, and that the mean medication possession ratio (0.64) was a robust measure of adherence over time. 39. Arellano F, Wentworth CE, Arana A, Fernandez C, Paul C. Risk of Lymphoma Following Exposure to Calcineurin Inhibitors and Topical Steroids in Patients with Atopic Dermatitis. Journal of Investigative Dermatology. 2007;127:808-16. http://www.ncbi.nlm.nih.gov/pubmed/17096020 The authors used IMS LifeLinkTM: Health Plan Claims data to perform a nested case-control study evaluating the association between topical immunosuppressants and lymphoma in a cohort of patients with atopic dermatitis. Conditional logistic regression analysis suggested that severity of atopic dermatitis was the main factor associated with an increased risk of lymphoma. 40. Berndt ER, Mortimer R, Bhattacharjya A, Parece A, Tuttle E. Authorized Generic Drugs, Price Competition and Consumers’ Welfare. Health Affairs. 2007;26:790-799. http://www.ncbi.nlm.nih.gov/pubmed/17485758 The authors used IMS National Sales Perspective™ and the National Prescription Audit™ data to analyze the effect of authorized generic entry on the timing of generic entry, brand-name and generic prices, and generic penetration. After the first four or five generic entrants, additional entrants appeared to have no effect on the long-run generic-to-brand price ratios. 41. Kuntze E, Ollendorf DA, et al. Reduced Mortality Rate after Intensive Statin Therapy in Managed-Care Patients. Value In Health. 2007;10:161-9. http://www.ncbi.nlm.nih.gov/pubmed/17391425 The authors used IMS LifeLinkTM: Health Plan Claims data to evaluate whether intensive statin therapy in a managed-care setting produces greater clinical benefit than more moderate statin use based on analyses of adults hospitalized for coronary heart disease (CHD) between 2000 and 2003. They found that high risk CHD patients benefit from intensive statin therapy in a real-world, managed-care cohort, with a 29% reduced risk of death compared with those receiving standard therapy. 42. Hoffman JM, Shah ND, Vermeulen LC, Schumock GT, Grim P, Hunkler RJ, Hontz KM. Projecting Future Drug Expenditures – 2007. American Journal of Health System Pharmacy. 2007;64:298-314. http://www.ncbi.nlm.nih.gov/pubmed/17244880 The authors used National Sales Perspectives™ (NSP) and National Prescription Audit™ (NPA) to analyze drug expenditure trends in 2005 and 2006, project drug expenditures for 2007, and examine factors likely to influence drug expenditures. 43. Naslund M, Black L, Eaddy M, Batiste LR. Differences in Alpha Blocker Usage Among Enlarged Prostate Patients Receiving Combination Therapy with 5 ARIs. American Journal of Managed Care. 2007;13Suppl1:S17-22. http://www.ncbi.nlm.nih.gov/pubmed/17295601 The authors used IMS LifeLinkTM: Health Plan Claims data to assess the likelihood and timing of alpha blocker discontinuation in patients receiving combination therapy with dutasteride or finasteride plus an alpha blocker. Patients with an enlarged prostate who were taking an alpha blocker and 5-alpha reductase inhibitor in combination discontinued their alpha blocker 20% earlier when taking dutasteride than when taking finasteride. 44. Issa MM, Runken MC, Grogg AL, Shah MB. A Large Retrospective Analysis of Acute Urinary Retention and Prostate-Related Surgery in BPH Patients Treated with 5-Alpha Reductase Inhibitors: Dutasteride versus Finasteride. American Journal of Managed Care. 2007;13Suppl1:S10-6. http://www.ncbi.nlm.nih.gov/pubmed/17295600 The authors used IMS LifeLinkTM: Health Plan Claims data to examine rates of acute urinary retention and surgery among patients age 50 or older diagnosed with benign prostatic hyperplasia (BPH) treated with 5-alpha reductase inhibitors (5ARIs). Patients treated with dutasteride were less likely to experience acute urinary retention than patients treated with finasteride (5.3% v 8.3%) and demonstrated a trend toward a lower likelihood of requiring surgery. 45. Jick SS, Jick H. The Contraceptive Patch in Relation to Ischemic Stroke and Acute Myocardial Infarction. Pharmacotherapy. 2007;27:218-20. http://www.ncbi.nlm.nih.gov/pubmed/17253912 The authors used IMS LifeLinkTM: Health Plan Claims data to compare rates of stroke and acute myocardial infarction in users of the Ortho EVRA contraceptive patch with these rates in users of norgestimate-containing oral contraceptives among females aged 15-45 who had filled at least one prescription for either type of contraceptive between 2002 and 2005. Both ischemic stroke and acute myocardial infarction were rare among young women who use hormonal contraceptives, and the data provided no suggestion of an increased risk of either in users of either type of contraceptive. 46. Prescott JD, Factor S, Pill M, Levi GW. Descriptive Analysis of the Direct Medical Costs of Multiple Sclerosis in 2004 Using Administrative Claims in a Large Nationwide Database. Journal of Managed Care Pharmacy. 2007;13:44-52. http://www.ncbi.nlm.nih.gov/pubmed/17269836 The authors used IMS LifeLinkTM: Health Plan Claims data to: 1) determine the average total and component direct medical costs incurred in the treatment of multiple sclerosis (MS) patients in 2004 and 2) compare MS treatment costs and cost factors in 2004 with 1995. Pharmacy costs accounted for 65% of total MS-related medical costs in 2004 and 75% of total costs for the subset of MS patients (58%) who receive at least 1 disease-modifying drug. Total annual MS-related treatment costs increased by 35% from 1995 to 2004. 47. Berndt ER, Danzon PM, Kruse GB. Dynamic Competition in Pharmaceuticals: Cross-National Evidence from New Drug Diffusion. Managerial and Decision Economics. 2007;28:231-250. The authors use IMS Health MIDAS™ data to examine differences in treatment intensity, daily doses and expenditures across countries, assess differences in prices (per daily dose) of new vs old medicines, and report cross-country differences in the promotion of prescription drugs for antihypertensives, antidepressants and antiepileptics. They found substantial variation across classes and countries in promotion and diffusion. Relative to other countries, the United States was in the middle when comparing relative prices of old vs new drugs. Differences across therapeutic classes were particularly striking. 48. Radley D, Finkelstein S, Stafford RS. Off-Label Prescribing Among Office-Based Physicians. Archives of Internal Medicine. 2006;166:1021-1026. http://www.ncbi.nlm.nih.gov/pubmed/16682577 The authors used the National Disease and Therapeutic Index™ (NDTI) to define prescribing patterns by diagnosis for 160 commonly prescribed drugs. They found that in 2001, there were an estimated 150 million off-label mentions among the sampled medications and that off-label use was most common among cardiac medications and anticonvulsants. 49. Stafford RS, Monti V, Furberg CD, Ma J. Long-Term and Short-Term Changes in Antihypertensive Prescribing by Office-Based Physicians in the U.S. Hypertension. 2006;48:213-8. http://www.ncbi.nlm.nih.gov/pubmed/16785334 The authors used the National Disease and Therapeutic Index™ (NDTI) to describe both long and short-term trends in US antihypertensive prescribing from 1990 through 2004. They found that diuretics ranked among the top 3 antihypertensive drug classes through this time span and that evidence-based clinical recommendations had an impact on prescribing practices, though small. 50. Lichtenberg FR. The Impact of Increased Utilization of HIV Drugs on Longevity and Medical Expenditure: An Assessment Based on Aggregate U.S. Time-Series Data. Expert Review of Pharmacoeconomics and Outcomes Research. 2006;6:425-436. http://www.nber.org/papers/w12406.pdf The author used National Prescription Audit™ (NPA) in combination with the CDC’s AIDS Public Information Data Set and data from AHRQ’s Nationwide Inpatient Sample to estimate the medical cost per life-year gained from increased utilization of HIV drugs. Estimates imply that actual life expectancy of HIV/AIDS patients in 2001 was 13.4 years higher than it would have been if the drug utilization rate had not increased from its 1993 level, and medical cost per additional life-year is estimated to have been $17,175, widely considered cost-effective. 51. Arellano FM, Ulcickas Yood M, Wentworth CE, et al. Use of Cyclo-Oxygenase 2 Inhibitors (COX-2) and Prescription Non-Steroidal Anti-Inflammatory Drugs (NSAIDS) in UK and USA Populations: Implications for COX-2 Cardiovascular Profile. Pharmacoepidemiology and Drug Safety. 2006;15:861-872. http://www.ncbi.nlm.nih.gov/pubmed/17086563 The authors combined IMS LifeLinkTM: Health Plan Claims data and The Health Improvement Network (THIN) data from the United Kingdom to describe the patterns of NSAIDS and COX-2 use between 1995-2004. Among the cohorts, COX-2 use was higher in the US (21%) than UK (16%). More COX-2 users than NSAIDS users received concomitant gastroprotective agents (GPA), corticosteroids and anti-platelet therapy, and had a history of thromboembolic events and hypertension. US patients were prescribed higher doses of both NSAIDS and COX-2. 52. Jumadilova Z, Varadharajan S, Girase P, Ollendorf DA. Retrospective Evaluation of Outcomes in Patients with Overactive Bladder Receiving Tolterodine Versus Oxybutynin. American Society of Health-System Pharmacists. 2006;63:2357-64. http://www.ncbi.nlm.nih.gov/pubmed/17106009 The authors used IMS LifeLinkTM: Health Plan Claims data to assess the frequency, relative risk, resource utilization, and costs related to comorbidities associated with overactive bladder (OAB) based on analyses of patients with OAB who initiated treatment between 1/2001-12/2002. They found that treatment of OAB patients with tolterodine ER was associated with reduced frequency, relative risk, medical and pharmacy resource utilization, and incurred costs related to selected OAB-associated comorbidities compared with treatment with oxybutynin ER or oxybutynin IR. 53. Ollendorf DA, Lidsky L. Infliximab Drug and Infusion Costs Among Patients with Crohn’s Disease in a Commercially-Insured Setting. American Journal of Therapeutics. 2006;13:502-6. http://www.ncbi.nlm.nih.gov/pubmed/17122530 The authors used IMS LifeLinkTM: Health Plan Claims data to evaluate actual expenditures for infliximab by examining patterns of administration and reimbursement among commercially-insured patients receiving infliximab for Crohn’s Disease (CD). The charged and paid amounts per vial billed averaged $927 and $583 respectively, so the true costs of administering infliximab are likely to be lower than reported for charged amounts. 54. Jick SS, Jick H. Cerebral Venous Sinus Thrombosis in Users of Four Hormonal Contraceptives: Levonorgestrel-Containing Oral Contraceptives, Norgestimate-Containing Oral Contraceptives, Desogestrel-Containing Oral Contraceptives and the Contraceptive Patch. Contraception. 2006;74:290-292. http://www.ncbi.nlm.nih.gov/pubmed/16982227 The authors used IMS LifeLinkTM: Health Plan Claims data to assess the risk of cerebral venous sinus thrombosis among women aged 15-44 years who filled at least one prescription for either the contraceptive patch or oral contraceptives. There was no evidence of an increased risk of cerebral venous sinus thrombosis in users of the contraceptive patch compared to users of levonorgestrel-containing oral contraceptives. 55. MacDougall DA, Feliu AL, Boccuzzi SJ, Lin J. Economic Burden of Deep-Vein Thrombosis, Pulmonary Embolism, and Post Thrombotic Syndrome. American Journal of Health System Pharmacy. 2006;63(20Suppl6):S5-15. http://www.ncbi.nlm.nih.gov/pubmed/17032933 The authors used IMS LifeLinkTM: Health Plan Claims data to determine the direct medical costs of a deep-vein thrombosis (DVT) or pulmonary embolism (PE) patient across the entire continuum of care based on claims data analysis of patients with a DVT or PE diagnosis and patients with possible evidence of post-thrombotic syndrome between 1997 and 2004. The initial acute DVT or PE event was associated with high total healthcare costs and these costs were further increased by subsequent events such as recurrent DVT or PE and post-thrombotic syndrome. 56. Brassard P, Kezouh A, Suissa S. Antirheumatic Drugs and The Risk of Tuberculosis. Clinical http://www.ncbi.nlm.nih.gov/pubmed/16912945 The authors used IMS LifeLinkTM: Health Plan Claims data to quantify the rate of tuberculosis (TB) among a cohort of patients with rheumatoid arthritis (RA) and to assess whether the independent use of disease-modifying antirheumatic drugs (DMARDs) is associated with the risk of developing TB. They used conditional logistic regression in a nested case-control analysis of all subjects with 1 or more diagnoses of RA from 1998 to 2003. The use of biological and traditional DMARDs was associated with an increased risk of developing TB, mainly among noncurrent users of corticosteroids. 57. McLaughlin TP, Khandker RK, Kruzikas DT, Tummala R. Overlap of Anxiety and Depression in a Managed Care Population: Prevalence and Association with Resource Utilization. Journal of Clinical Psychiatry. 2006;67:1187-93. http://www.ncbi.nlm.nih.gov/pubmed/16965195 The authors used IMS LifeLinkTM: Health Plan Claims data to characterize the diagnosis of anxiety and depression within a large managed care population and to measure the impact of having both of these conditions on treatment patterns, health care utilization, and cost. The combination of anxiety and depression was fairly common, patients with both conditions tended to have more somatic complaints, a higher incidence of antidepressant use, incur the highest utilization of medical services, and have the highest medical costs. 58. Suissa S, Bernatsky S, Hudson M. Antirheumatic Drug Use and the Risk of Acute Myocardial Infarction. Arthritis & Rheumatism. 2006;55:531-6. http://www.ncbi.nlm.nih.gov/pubmed/16874796 The authors used IMS LifeLinkTM: Health Plan Claims data to assess the risk of acute myocardial infarction associated with the use of disease-modifying antirheumatic drugs (DMARDs) and other medications commonly used in rheumatoid arthritis. The use of DMARDs was associated with a reduction in acute myocardial infarction risk among patients with rheumatoid arthritis. 59. Hawkins RG, Houston MC. Is Population-Wide Diuretic Use Directly Associated With the Incidence of End-Stage Renal Disease in the United States? A Hypothesis. American Journal of Hypertension. 2006;19:565-7. http://www.ncbi.nlm.nih.gov/pubmed/15925729 The authors used MIDAS™ along with a national databases for all-cause cardiovascular disease (CVD) mortality and stroke mortality from the National Vital Statistics Registry, and US Renal Data Service information to determine whether changes in drug use patterns are predictive of disease emergence in the US from 1980-98. Increasing annual diuretic distribution was directly associated with accelerated time-lagged growth rates of end-stage renal disease (ESRD) incidence. 60. Allen-Ramey FC, Bukstein D, Luskin A, Sajjan SG, Markson LE. Administrative Claims Analysis of Asthma-Related Health Care Utilization for Patients who Received Inhaled Corticosteroids with Either Montelukast or Salmeterol as Combination Therapy. Journal of Managed Care Pharmacy. 2006;12:310-21. http://www.ncbi.nlm.nih.gov/pubmed/16792437 The authors used IMS LifeLinkTM: Health Plan Claims data to compare asthma-related health care resource utilization among a matched cohort of asthma patients between the ages of 4-55 years using inhaled corticosteroids (ICSs) plus either montelukast (MON) or salmeterol (SAL) as combination therapy for asthma. The use of ICS/MON compared with ICS/SAL resulted in similar odds of oral corticosteroid fills, decreased odds of Emergency Department visits and asthma-related hospitalizations, but higher utilization of short-acting beta-agonist (SABA) fills. 61. Suissa S, Hudson M, Ernst P. Leflunomide Use and The Risk of Interstitial Lung Disease in Rheumatoid Arthritis. Arthritis & Rheumatism. 2006;54:1435-9. http://www.ncbi.nlm.nih.gov/pubmed/16645972 The authors used IMS LifeLinkTM: Health Plan Claims data to asses the risk of interstitial lung disease in patients with rheumatoid arthritis treated with leflunomide, a disease-modifying antirheumatic drug (DMARD), between 1998 and 2003. They found that reports of interstitial lung disease associated with leflunomide use were likely the result of the channeling of high-risk patients to leflunomide treatment, particularly those with a history of methotrexate use or preexisting ILD. 62. Joyce AT, Harrison DJ, Loebel AD, Carter CT, Ollendorf DA. Effect of Initial Ziprasidone Dose on Length of Therapy in Schizophrenia. Schizophrenia Research. 2006;83:285-92. http://www.ncbi.nlm.nih.gov/pubmed/16545543 The authors used IMS LifeLinkTM: Health Plan Claims data to examine the effects of initial ziprasidone dose on discontinuation rates in patients 18 years or older with a diagnosis of schizophrenia or schizoaffective disorder and a ziprasidone claim between 2001 and 2003. Patients initiating ziprasidone with an initial dose of at least 120 mg/day had better medication adherence compared to those initiating at lower doses. 63. Black L, Naslund MJ, Gilbert TD Jr, Davis EA, Ollendorf DA. An Examination of Treatment Patterns and Costs of Care Among Patients with Benign Prostatic Hyperplasia. American Journal of Managed Care. 2006;12:S99-S110. http://www.ncbi.nlm.nih.gov/pubmed/16551208 The authors used IMS LifeLinkTM: Health Plan Claims data to examine utilization and costs of care for benign prostatic hyperplasia (BPH)-related services in a large cohort of commercially insured persons. The sample included men age 45 and older who were newly diagnosed with BPH between 2000 and 2001. The results suggest that most patients undergo watchful waiting in the year after diagnosis, while rates of surgery and adverse events were low but costly. 64. Jick SS, Kaye JA, Russmann S, Jick H. Risk of Nonfatal Venous Thromboembolism in Women Using a Contraceptive Transdermal Patch and Oral Contraceptives Containing Norgestimate and 35 Microg of Ethinyl Estradiol. Contraception. 2006;73:223-8. http://www.ncbi.nlm.nih.gov/pubmed/16472560 The authors used IMS LifeLinkTM: Health Plan Claims data to assess the risk of nonfatal venous thromboembolism (VTE) in women aged 15-44, who either started using a new transdermal contraceptive patch or norgestimate-35 oral contraceptives after 4/2002. They found that the risk of nonfatal VTE for the patch is similar to the risk for oral contraceptives (OR 0.9 with 95% CI 0.5-1.6). 65. Keating KN, Friedman HS, Perfetto EM. Moxifloxacin Versus Levofloxacin for Treatment of Acute Rhinosinusitis: A Retrospective Database Analysis of Treatment Duration, Outcomes, and Charges. Current Medical Research and Opinion. 2006; 22:327-33. http://www.ncbi.nlm.nih.gov/pubmed/16466604 The authors used IMS LifeLinkTM: Health Plan Claims data to examine how labeled recommendations for duration of moxifloxacin and levofloxacin treatment of acute bacterial rhinosinusitis compared with real-world practice, and compare the failure and recurrence rates, and associated charges, based on analyses of claims searched over a 3-year period for episodes of acute rhinosinusitis treated within 5 days with moxifloxacin or levofloxacin. Shorter treatment durations seen for moxifloxacin reflected the label- recommended duration for acute rhinosinusitis, resulted in better outcomes than levofloxacin re: risk of treatment failure and recurrence, and lower total charges. 66. Hoffman JM, Shah ND, Vermeulen LC, Schumock GT, Grim P, Hunkler RJ, Hontz KM. Projecting Future Drug Expenditures – 2006. American Journal of Health System Pharmacy. 2006;63:123-38. http://www.ncbi.nlm.nih.gov/pubmed/16390926 The authors used National Sales Perspectives™ (NSP) and National Prescription Audit™ (NPA) to analyze drug expenditure trends in 2004 and 2005, project drug expenditures for 2006, and examine factors likely to influence drug expenditures. 67. Wilensky J, Fiscella RG, Carlson AM, Morris LS, Walt J. Measurement of Persistence and Adherence to Regimens of IOP-Lowering Glaucoma Medications Using Pharmacy Claims Data. American Journal of Ophthalmology. 2006;141:S28-33. http://www.ncbi.nlm.nih.gov/pubmed/16389058 The authors used IMS LifeLinkTM: Health Plan Claims data to determine persistence and adherence of glaucoma patients to therapeutic regimens of prostaglandin/prostamide-class medications to lower intraocular pressure. Overall, patients taking prostaglandin/prostamide medications had a mean adherence rate of 76%. 68. Stafford RS, Drieling R, Johns R, Ma J. National Patterns of Calcium Use in Osteoporosis. Journal of Reproductive Medicine. 2005; 11(Suppl): 885-895. http://www.ncbi.nlm.nih.gov/pubmed/16422278 The authors used the National Disease and Therapeutic Index™ (NDTI) to determine whether the recent therapeutic dominance of bisphosphonates in osteoporosis treatment may have led calcium to be neglected as a component of effective management. They found that physician visits for osteoporosis in the US increased 4.5-fold between 1994 and 2004 and that during this time the proportion of visits in which bisphosphonates were prescribed increased from 14% to 81%, while reported calcium use fell from 43% to 23% of visits. 69. Lichtenberg FR. Pharmaceutical Innovation and The Burden of Disease in Developing Countries. Journal of Medicine and Philosophy. 2005; 30:663-90. http://www.ncbi.nlm.nih.gov/pubmed/16396790 The author used drug launch data from MIDAS™ to analyze the relationship across diseases between pharmaceutical innovation and the burden of disease in developed and developing countries. Two analyses indicate that the amount of pharmaceutical innovation is positively related to the burden of disease in developed countries but not to the burden of disease in developing countries. 70. Lichtenberg FR. The Impact of New Drug Launches on Longevity: Evidence from Longitudinal Disease-Level Data From 52 Countries, 1982-2001. International Journal of Health Care Finance and Economics. 2005; 5:47-73. http://www.ncbi.nlm.nih.gov/pubmed/15714263 The author used drug launch data from MIDAS™ to perform an econometric analysis of the effect of new drug launches on longevity. Under conservative assumptions, estimates imply that the average annual increase in life expectancy of the entire population resulting from new drug launches is about one week and that the incremental cost effectiveness ratio is about $6,750 – far lower than most estimates of the value of a statistical life-year. 71. Lee WC, Hoffmann MS, Arcona S, D'Souza J, Wang Q, Pashos CL. A Cost Comparison of Alternative Regimens for Treatment-Refractory Partial Seizure Disorder: An Econometric Analysis. Clinical Therapeutics. 2005;27:1629-38. http://www.ncbi.nlm.nih.gov/pubmed/16330300 The authors used IMS LifeLinkTM: Health Plan Claims data to examine the economic costs associated with treatment-refractory partial seizure disorder and to compare the costs of two alternative approaches: a switch to oxcarbazepine monotherapy or the addition of another antiepileptic drug. Patients who had a drug added on were significantly more likely than those who were switched to have an emergency room visit after the failure of the initial regimen. 72. Stempel DA, McLaughlin TP, Stanford RH. Treatment Patterns for Pediatric Asthma Prior to and After Emergency Department Events. Pediatric Pulmonology. 2005;40:310-5. http://www.ncbi.nlm.nih.gov/pubmed/16010682 The authors used IMS LifeLinkTM: Health Plan Claims data to describe the asthma treatment patterns in children aged 1-17 years in the year prior to and 2 months after an emergency department (ED) event. They found that an ED event results in only an incremental and transient increase in inhaled corticosteroid-containing controller treatment. 73. Joyce AT, Harrison DJ, Loebel AD, Ollendorf DA. Impact of Atypical Antipsychotics on Outcomes of Care in Schizophrenia. The American Journal of Managed Care. 2005;11:S254-61. http://www.ncbi.nlm.nih.gov/pubmed/16180964 The authors used IMS LifeLinkTM: Health Plan Claims data to compare persistence, compliance, and psychiatric treatment costs in adults with schizophrenia having claims for atypical antipsychotics from 2001 through 2003. Patients initiated on ziprasidone had longer persistence, better compliance, and greater decreases in psychiatric-related costs than those initiated on other atypicals. 74. Schatz M, Leibman C. Inhaled Corticosteroid Use and Outcomes in Pregnancy. Annals of Allergy, Asthma, & Immunology. 2005;95:234-8. http://www.ncbi.nlm.nih.gov/pubmed/16200813 The authors used IMS LifeLinkTM: Health Plan Claims data to examine asthma medication use and asthma-related health care use before and during pregnancy among women age 15-45 with both a pregnancy and asthma claim. They found that for patients using an inhaled corticosteroid before pregnancy, the rate of asthma-related physician visits decreased and the number of emergency room visits was unchanged after pregnancy, whereas physician and emergency room visits increased after pregnancy for patients not using an inhaled corticosteroid before pregnancy. 75. Lee WC, Arcona S, Thomas SK, Wang Q, Hoffmann MS, Pashos CL. Effect of Comorbidities on Medical Care Use and Cost Among Refractory Patients With Partial Seizure Disorder. Epilepsy & Behavior. 2005;7:123-6. http://www.ncbi.nlm.nih.gov/pubmed/15939673 The authors used IMS LifeLinkTM: Health Plan Claims data to assess the effect of comorbidities on medical care use and costs among patients with partial seizure disorder who were refractory to initial antiepileptic drug monotherapy based on analyses of claims collected for adult patients treated with monotherapy between 2000 and 2002. They found that for patients refractory to initial AED monotherapy, the presence of comorbidities, especially depression, was associated with a substantial increase in medical care use and costs. 76. MacDougall C, Powell JP, Johnson CK, Edmond MB, Polk RE. Hospital and Community Fluoroquinolone Use and Resistance in Staphylococcus Aureus and Escherichia Coli in 17 US Hospitals. Clinical Infectious Diseases. 2005;41:435-40. http://www.ncbi.nlm.nih.gov/pubmed/16028149 The authors used Xponent™ to determine whether variability in hospital percentages of fluoroquinoloneresistant E. coli and methicillin-resistant Staphylococcus aureus (MRSA) were associated with fluoroquinolone use in hospitals and their surrounding communities. They found associations between fluoroquinolone use in hospitals and methicillin resistance in S. aureus and between fluoroquinolone use in communities and fluoroquinolone resistance in E. coli in hospitals. 77. Perfetto EM, Subedi P, Jumadilova Z. Treatment of Overactive Bladder: A Model Comparing Extended-Release Formulations of Tolterodine and Oxybutynin. American Journal of Managed Care. 2005;11(4 Suppl):S150-7. http://www.ncbi.nlm.nih.gov/pubmed/16161388 The authors used IMS LifeLinkTM: Health Plan Claims data to compare 1-year total healthcare costs for patients with overactive bladder initiating treatment with extended-release formulations of tolterodine and oxybutynin: tolterodine tartrate extended-release capsules (tolterodine ER) v. extended-release oxybutynin chloride (oxybutynin ER). Tolterodine ER users had lower monthly drug and medical costs, and a total average annual cost savings of $204 per patient. Patients with overactive bladder were more likely to remain on original drug treatment taking tolterodine ER v. oxybutynin ER. 78. Varadharajan S, Jumadilova Z, Girase P, Ollendorf DA. Economic Impact of Extended-Release Tolterodine Versus Immediate- and Extended-Release Oxybutynin Among Commercially-Insured Persons with Overactive Bladder. The American Journal of Managed Care. 2005;11:S140-9. http://www.ncbi.nlm.nih.gov/pubmed/16161387 The authors used IMS LifeLinkTM: Health Plan Claims data to examine levels of persistence and compliance as well as the economic impact of tolterodine ER v. oxybutynin IR or ER among commercially-insured patients with overactive bladder. Use of tolterodine ER resulted in comparable compliance to oxybutynin ER and longer duration of use relative to either form of oxybutynin. 79. Wingard JR, Wood CA, Sullivan E, Berger ML, Gerth WC, Mansley EC. Caspofungin versus Amphotericin B for Candidemia: A Pharmacoecomomic Analysis. Clinical Therapeutics. 2005;27:960-969. http://www.ncbi.nlm.nih.gov/pubmed/16117996 The authors used National Sales Perspectives™ (NSP) to examine whether cost savings generated from the reduced rates of impaired renal function observed in a clinical trial would be enough to offset the higher acquisition cost of caspofungin relative to ampho B. They found that based only on differences in drug acquisition cost and renal toxicity, the use of caspofungin instead of ampho B in patients with candidemia may be a cost-saving strategy from a hospital’s perspective. 80. Ollendorf DA, Massarotti E, Birbara C, Burgess S. Frequency, Predictors, and Economic Impact of Upward Dose Adjustment of Infliximab in Managed Care Patients with Rheumatoid Arthritis. Journal of Managed Care Pharmacy. 2005;11:383-93. http://www.ncbi.nlm.nih.gov/pubmed/15934797 The authors used IMS LifeLinkTM: Health Plan Claims data to examine dosing patterns and costs among rheumatoid arthritis (RA) patients newly treated with infliximab between 2000 and 2002. They found that upward dose adjustment with infliximab was frequent and appeared to occur earlier in the drug therapy in 2002 v. 2000 and that upward dose adjustment was associated with significant increases in drug treatment costs. 81. Rajagopalan R, Iyer S, Perez A. Comparison of Pioglitazone With Other Antidiabetic Drugs for Associated Incidence of Liver Failure: No Evidence of Increased Risk of Liver Failure with Pioglitazone. Diabetes, Obesity, and Metabolism. 2005;7:161-9. http://www.ncbi.nlm.nih.gov/pubmed/15715889 The authors used IMS LifeLinkTM: Health Plan Claims data to assess the incidence of liver failure in association with antidiabetic treatment using pioglitazone v. other oral antidiabetic medications. They found no evidence of increased risk of liver failure or hepatitis for patients initiating therapy on pioglitazone, compared to other oral antidiabetic agents. 82. Hoffman JM, Shah ND, Vermeulen LC, Hunkler RJ, Hontz KM. Projecting Future Drug Expenditures – 2005. American Journal of Health System Pharmacy. 2005;62:149-67. http://www.ncbi.nlm.nih.gov/pubmed/15700889 The authors used National Sales Perspectives™ (NSP) and National Prescription Audit™ (NPA) to analyze drug expenditure trends in 2003 and 2004, project drug expenditures for 2005, and examine factors likely to influence drug expenditures. 83. Joyce AT, Iacoviello JM, Nag S, Sajjan S, Jilinskaia E, Throop D, Pedan A, Ollendorf DA, Alexander CM. End Stage Renal Disease-Associated Managed Care Costs Among Patients With and Without Diabetes. Diabetes Care. 2004;27:2829-35. http://www.ncbi.nlm.nih.gov/pubmed/15562193 The authors used IMS LifeLinkTM: Health Plan Claims data to examine the direct costs of care before and after onset of end stage renal disease (ESRD) for patients with and without diabetes based on analyses of claims of patients with onset of ESRD between 1998 and 2002. The economic burden of ESRD in the year after onset is substantial, particularly among patients with diabetes. 84. Packer C, Stevens A, Cook A, Raftery J. Diffusion of Thromboysis for Acute Myocardial Infarction From 1981 to 2000 In England: Trend Analysis and Comparison With Need. International Journal of Technology Assessment in Health Care. 2004;20:531-536. http://www.ncbi.nlm.nih.gov/pubmed/15609806 The authors use MIDAS™ to describe the adoption and take up of thrombolytic agents for acute myocardial infarction since 1980 in England and compare use with the estimated ceiling of need. They found that although there was a rapid initial uptake of thrombolysis in England, usage took 8 years to reach the ceiling of clinical need of 65% of patients with acute myocardial infarction, with many patients missing the opportunity to benefit. 85. Rajagopalan R, Rosenson RS, Fernandes AW, Khan M, Murray FT. Association Between Congestive Heart Failure and Hospitalization in Patients With Type 2 Diabetes Mellitus Receiving Treatment With Insulin or Pioglitazone: A Retrospective Data Analysis. Clinical Therapeutics. 2004;26:1400-10. http://www.ncbi.nlm.nih.gov/pubmed/15531002 The authors used IMS LifeLinkTM: Health Plan Claims data to assess the congestive heart failure risk in patients with type 2 diabetes mellitus and to compare the association with CHF in those receiving pioglitazone and those receiving insulin. Pioglitazone therapy was associated with significantly lower incidence rates of CHF and inpatient hospitalization compared with insulin therapy. 86. Seftel AD, Sun P, Swindle R. The Prevalence of Hypertension, Hyperlipidemia, Diabetes Mellitus and Depression among Men with Erectile Dysfunction. Journal of Urology. 2004;171:2341-2345. http://www.ncbi.nlm.nih.gov/pubmed/15126817 The authors used IMS LifeLinkTM: Health Plan Claims data to quantify the prevalence of diagnosed hypertension, hyperlipidemia, diabetes mellitus and depression in male health plan members with erectile dysfunction from 1995 to 2002. Each of the conditions was prevalent among the patients, hypertension (42%) and hyperlipidemia (42%) were the most common. 87. Stafford RS, Drieling RL, Hersh AL. National Trends in Osteoporosis Visits and Osteoporosis Treatment, 1988-2003. Archives of Internal Medicine. 2004;164:1525-1530. http://www.ncbi.nlm.nih.gov/pubmed/15277283 The authors used the National Disease and Therapeutic Index™ (NDTI) to investigate patterns of pharmacotherapy from 1988-2003 and the impact of new medications on identification and treatment of patients with osteoporosis. They found that new medications for osteoporosis offering improved efficacy and convenient dosing were associated with increased frequency of patient visits and treatment. 88. Guda NM, Vakil N. Proton Pump Inhibitors and The Time Trends for Esophageal Dilation. American Journal of Gastroenterology. 2004;99:797-800. http://www.ncbi.nlm.nih.gov/pubmed/15128339 The authors used the computerized databases of two large community hospitals and National Prescription Audit™ (NPA) data to determine the time trends for upper endoscopy and stricture dilation before and after the availability of proton pump inhibitors from 1986 through 2001. The need for stricture dilation peaked in 1994 (from 4% of patients in 1989 to 6% in 1994), and has declined thereafter, corresponding to an increase in the use of proton pump inhibitors. However, the need for esophageal dilation has not been abolished. 89. Hoffman JM, Shah ND, Vermeulen LC, Hunkler RJ, Hontz KM. Projecting Future Drug Expenditures – 2004. American Journal of Health System Pharmacy. 2004;61:145-58. http://www.ncbi.nlm.nih.gov/pubmed/14750400 The authors used National Sales Perspectives™ (NSP) and National Prescription Audit™ (NPA) to analyze drug expenditure trends since 2002, project drug expenditures for 2004, and examine factors likely to influence drug expenditures. 90. Ollendorf D, Joyce A, Rucker M. Rate of New-Onset Diabetes Among Patients Treated With Atypical or Conventional Antipsychotic Medications for Schizophrenia. Medscape General Medicine. 2004;6:1-12. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1140712/ The authors used IMS LifeLinkTM: Health Plan Claims data to compare the rates of new-onset diabetes mellitus between patients treated for schizophrenia with atypical or conventional antipsychotics. Patients with schizophrenia treated with atypical antipsychotics had a moderately increased risk of diabetes relative to those treated with conventional antipsychotics, as measured by Cox proportional hazard models (hazard ratio [HR] = 1.17, 95% confidence interval [CI] = 1.06, 1.30). 91. Stafford RS, Furberg CD, Finkelstein SN, Cockburn IM, Alehegn T, Ma J. Impact of Clinical Trial Results on National Trends of Alpha Blockers Prescribing Trends, 1996-2002. Journal of the American Medical Association. 2004;291:54-62. http://www.ncbi.nlm.nih.gov/pubmed/14709576 The authors used the National Prescription Audit™ (NPA), National Disease and Therapeutic Index™ (NDTI), IMS market research reports, and a random sample of pharmacies and mass merchandise and discount houses to examine the changes in the prescription of alpha blockers for hypertension treatment before and after the April 2000 publication of the unfavorable Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). There were modest yet statistically significant declines in the use of doxazosin and other alpha blockers that coincided with the early termination of the ALLHAT doxazosin arm. 92. Valuck RJ, Libby AM, Sills MR, Giese AA, Allen RR. Antidepressant Treatment and Risk of Suicide Attempt by Adolescents With Major Depressive Disorder: A Propensity-Adjusted Retrospective Cohort Study. CNS Drugs. 2004; 18:1119-32. http://www.ncbi.nlm.nih.gov/pubmed/15581382 The authors used IMS LifeLinkTM: Health Plan Claims data to examine the potential empirical link between antidepressant treatment and suicide attempts among adolescents aged 12-18 years. They found that antidepressant medication use had no statistically significant effect on the likelihood of suicide attempt after propensity adjustment for treatment allocation and controlling for other factors. 93. Donohue JM, Berndt ER, Rosenthal M, Epstein AM, Frank RG. Effects of Pharmaceutical Promotion on Adherence to Guideline Treatment of Depression. Medical Care. 2004;42:1176-1185. http://www.ncbi.nlm.nih.gov/pubmed/15550797 The authors used IMS Health Integrated Promotions Services™ and MarketScan medical claims database to analyze the impact of consumer- and physician- directed marketing of antidepressants on the likelihood of being prescribed an antidepressant for a new episode of depression and the duration of antidepressant treatment. Direct-to-consumer advertising (DTCA) had a significant impact on the odds of prescription receipt while free samples had no effect. 94. Majumdar SR, Almasi EA, Stafford RS. Promotion and Prescribing of Hormone Therapy After Report by the Women’s Health Initiative. 2004;292:1983-1988. http://www.ncbi.nlm.nih.gov/pubmed/15507584 The authors used data from IMS Health’s National Prescription Audit™ (NPA) and Integrated Promotional Services™ (IPS), in conjunction with Consumer Media Reports to describe promotional expenditures before and after the publication of the Women’s Health Initiative trial in July 2002. The authors found a 32% decrease in hormone therapy prescriptions within nine months of the publication and a decrease in all promotional activities examined. 95. T, Geissler EC, Wan GJ. Comorbidities and Associated Treatment Charges in Patients With Anxiety Disorders. Pharmacotherapy. 2003;23:1251-6. http://www.ncbi.nlm.nih.gov/pubmed/14594343 The authors used IMS LifeLinkTM: Health Plan Claims data to describe comorbidities and treatment charges in patients receiving initial anxiolytic therapy for anxiety disorders. Many chronic conditions were commonly associated with anxiety disorders, with hypertension the most common non-psychiatric comorbidity (22%) and depression the most common psychiatric comorbidity (37%). Treatment charges were significantly higher for patients diagnosed with an anxiety disorder.

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My Journey with Schizophrenia (Excerpts) For the last 8 years (since age 33) I have been experiencing mental health issues – and was diagnosed with schizophrenia and mild depression. While there have been many ‘down’ moments, I have discovered a lot of good out of it as well. For instance, for the last two years I have been living independently. Around May this year I will mov

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General frequently asked questions How many.? Why do.? Who is.? Does it.? What stops.? What are.? How many people have literacy difficulties in Ireland? In 1997 the OECD developed an international survey which examined how wel adults could cope with different types of reading and numeracy tasks which crop up regularly in work and in daily life. The survey looked at how adults of worki

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