title: The economic effect of switching from sildenafil to another phosphodiesterase type 5 inhibitor.
abstract: Patients who could benefit from additional education about treatments for erectile dysfunction (ED) may prematurely discontinue or switch ED medications, resulting in unnecessary resource utilization. In a retrospective cohort study using a large, aggregated health claims database, the costs associated with switching from sildenafil to another phosphodiesterase type 5 (PDE-5) inhibitor were compared with those for patients refilling sildenafil. Of the 15,584 patients with an index sildenafil claim, 10,863 had a second PDE-5 inhibitor prescription (10,137 for sildenafil, 726 for vardenafil or tadalafil). Erectile dysfunction-attributable costs in the six-month preindex period were similar (P = .72), but postindex six-month ED costs were higher in patients who initially switched from sildenafil (dollar 173.38) versus patients who refilled sildenafil (dollar 131.51; P < .001). Regression analysis estimated that corrected ED-attributable and overall costs were 41% (P < .001) and 43% (P < .001) higher for patients who switched versus those who refilled sildenafil, respectively.
authors.affiliation: U.S. Outcomes Research, Pfizer Inc, New York City, NY 10017, USA. james.harnett@pfizer.com
authors.forename: James P
authors.initials: JP
authors.lastname: Harnett
authors.forename: Trent P
authors.initials: TP
authors.lastname: McLaughlin
authors.forename: John P
authors.initials: JP
authors.lastname: Mulhall
authors.forename: David
authors.initials: D
authors.lastname: Russell
authors.forename: Sean
authors.initials: S
authors.lastname: McLean
mesh_terms: D000368:Aged; D015331:Cohort Studies; D016527:Drug Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D010726:Phosphodiesterase Inhibitors / Q000627:therapeutic use*; D010879:Piperazines / Q000627:therapeutic use*; D011687:Purines; D012189:Retrospective Studies; D000068677:Sildenafil Citrate; D013450:Sulfones
chemical_list: D010726:Phosphodiesterase Inhibitors; D010879:Piperazines; D011687:Purines; D013450:Sulfones; D000068677:Sildenafil Citrate