title: Identification and management of oral isotretinoin use inconsistent with product labeling.
abstract: A pharmacy claims database was assessed retrospectively to analyze which antiacne medications patients had used in the six months before receiving oral isotretinoin. Before being given a prescription for oral isotretinoin, at least 47% of patients in the database, and possibly as many as 72%, had not received conventional therapy (at minimum, a topical retinoid and an oral antibiotic), as advised in the product labeling. A prior authorization policy restricting oral isotretinoin to patients who were unresponsive to a topical retinoid, at least two other topical medications, and two oral antibiotics reduced oral isotretinoin utilization by 47% and the per member per month spend by 35%.
authors.affiliation: Trade Relations, Health Net Pharmaceutical Services, Rancho Cordova, California, USA.
authors.forename: Scott
authors.initials: S
authors.lastname: Wert
mesh_terms: D000014:Abnormalities, Drug-Induced; D000152:Acne Vulgaris / Q000188:drug therapy*; D000284:Administration, Oral; D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D001130:Arizona; D016303:Clinical Pharmacy Information Systems; D004348:Drug Labeling; D017723:Drug Utilization Review; D005260:Female; D006279:Health Maintenance Organizations / Q000458:organization & administration* / Q000592:standards; D006302:Health Services Research; D006801:Humans; D015474:Isotretinoin / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D010349:Patient Compliance; D011247:Pregnancy; D012189:Retrospective Studies
chemical_list: D015474:Isotretinoin