Persistence with COX-2 inhibitors in managed care: an analysis of claims data.
Drug tolerability strongly influences patients' persistence with treatment. In this study, patterns of medication persistence with cyclooxygenase 2 (COX-2)-specific inhibitors and nonspecific nonsteroidal anti-inflammatory drugs (NSAIDs) were compared in a managed care setting. Pharmacy, enrollment, and medical claims data from 19 health plans were used to match subjects newly treated with celecoxib, rofecoxib, ibuprofen, naproxen, or diclofenac between July 1, 1999 and June 30, 2000. By using multiple regression analysis, users of COX-2-specific inhibitors were found to be 56.8% less likely to discontinue medication use and 60.3% less likely to switch treatment than were users of nonspecific NSAIDs (P < .001). Celecoxib users were 4.6% less likely to discontinue treatment than were rofecoxib users (P < .001). The greater persistence observed among users of COX-2 inhibitors might reflect improved treatment efficacy and patient satisfaction.
Harley
Carolyn
C
Research and Data Solutions at Ingenix, Inc., Eden Prairie, Minnesota, USA.
Wagner
Samuel
S
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000191:economics / Q000627:therapeutic use*; D001168:Arthritis / Q000145:classification / Q000188:drug therapy* / Q000191:economics; D000068579:Celecoxib; D051546:Cyclooxygenase 2; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors / Q000191:economics / Q000627:therapeutic use*; D004008:Diclofenac / Q000627:therapeutic use; D017723:Drug Utilization Review / Q000706:statistics & numerical data*; D005260:Female; D017048:Health Care Costs / Q000145:classification / Q000706:statistics & numerical data; D006801:Humans; D007052:Ibuprofen / Q000627:therapeutic use; D007345:Insurance Claim Review; D007527:Isoenzymes; D007783:Lactones / Q000627:therapeutic use; D008297:Male; D008329:Managed Care Programs / Q000191:economics* / Q000458:organization & administration; D008565:Membrane Proteins; D008875:Middle Aged; D009288:Naproxen / Q000627:therapeutic use; D010349:Patient Compliance / Q000706:statistics & numerical data*; D016016:Proportional Hazards Models; D011451:Prostaglandin-Endoperoxide Synthases; D011720:Pyrazoles; D012044:Regression Analysis; D013449:Sulfonamides / Q000627:therapeutic use; D013450:Sulfones; D014481:United States
D000894:Anti-Inflammatory Agents, Non-Steroidal; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors; D007527:Isoenzymes; D007783:Lactones; D008565:Membrane Proteins; D011720:Pyrazoles; D013449:Sulfonamides; D013450:Sulfones; C116926:rofecoxib; D004008:Diclofenac; D009288:Naproxen; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human; D011451:Prostaglandin-Endoperoxide Synthases; D000068579:Celecoxib; D007052:Ibuprofen