title: Effectiveness of tegaserod therapy on GI-related resource utilization in a managed care population.
abstract: This study sought to determine the real-world effectiveness of tegaserod therapy on gastrointestinal (GI)-related resource utilization in a managed care population with a retrospective, longitudinal pre-/post-parallel cohort study of tegaserod users and a matched reference cohort of tegaserod nonusers through medical and pharmacy claims data from a large, geographically diverse, managed care organization. Continuously enrolled benefit-eligible patients newly initiated on tegaserod therapy (index prescription) were identified between August 1, 2002, and June 30, 2003, and were categorized (using International Statistical Classification of Diseases, 9th Revision, Clinical Modification codes) as having irritable bowel syndrome (IBS) or another GI-related disorder (e.g., gastroesophageal reflux disease). GI-related resource utilization (office visits, hospitalizations, emergency department visits, endoscopic and nonendoscopic procedures, and GI drug prescriptions) was determined for the 6-month period before and after the index prescription date for tegaserod users and nonusers. The study population consisted of 3365 tegaserod users and 3364 matched nonusers. Within-cohort differences before and after therapy were tested using the Wilcoxon signed rank test. The mean age of 3365 tegaserod users and 3364 matched nonusers was 47 years (+/-15 years); 92% were women, 47% had an index diagnosis of IBS, and 53% had an index diagnosis of another GI-related disorder. Within-cohort GI resource utilization comparisons before and after therapy initiation showed significant decreases (P < .01) in all utilization categories, except GI drug prescriptions, for tegaserod users; these decreases were not consistently observed for matched nonusers. Tegaserod use appeared to be associated with consistent decreases in GI-related resource utilization after 6 months of therapy; similarly consistent reductions were not observed in tegaserod nonusers. These early findings suggest that tegaserod may provide important clinical and economic benefits.
authors.affiliation: Aetna Health Information Solutions, Blue Bell, Pennsylvania, USA.
authors.forename: Judith J
authors.initials: JJ
authors.lastname: Stephenson
authors.forename: Victoria
authors.initials: V
authors.lastname: Barghout
authors.forename: Kristijan H
authors.initials: KH
authors.lastname: Kahler
authors.forename: Joaquim
authors.initials: J
authors.lastname: Fernandes
authors.forename: Jane F
authors.initials: JF
authors.lastname: Beaulieu
authors.forename: Samuel
authors.initials: S
authors.lastname: Joo
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Boccuzzi
mesh_terms: D000328:Adult; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007211:Indoles / Q000627:therapeutic use*; D007345:Insurance Claim Review; D043183:Irritable Bowel Syndrome / Q000188:drug therapy*; D008137:Longitudinal Studies; D008329:Managed Care Programs / Q000706:statistics & numerical data*; D008875:Middle Aged; D009819:Office Visits / Q000706:statistics & numerical data; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D017366:Serotonin Receptor Agonists / Q000627:therapeutic use*; D014481:United States; D014600:Utilization Review
chemical_list: D005765:Gastrointestinal Agents; D007211:Indoles; D017366:Serotonin Receptor Agonists; C105050:tegaserod