Characterizing early prescribers of newly marketed drugs in Canada: a population-based study.
BACKGROUND
The diffusion of innovations model proposes that early adopters of innovation influence others. This study was undertaken to determine if early prescribers and users of newly marketed drugs had different sociodemographic and professional characteristics as compared to majority and late users and prescribers.


METHODS
After market availability in Manitoba, Canada, of celecoxib, alendronate, clopiodogrel and pantoprazole, time to first prescriptions was determined. Early, majority and late adopters of the new drug were characterized by this diffusion time. The prescription, health and prescriber records were compared across adopter categories. The likelihood of being an early or late prescriber or user of the new medications according to patient demographic characteristics, physician factors (specialty and place of training) and neighborhood income was determined with polytomous logistic regression.


RESULTS
Celecoxib demonstrated a much more rapid uptake into routine use than the other drugs. More than 300 Manitoba physicians prescribed celecoxib within two weeks of market availability. Early prescribers of celecoxib were more likely than majority prescribers to be general practitioners (OR = 1.81, 95%CI: 1.40-2.35) and have hospital affiliations (OR = 1.35, 95%CI: 1.03-1.77). Early users of celecoxib were more likely than the majority to have arthritic conditions, have a high income and have paid out-of-pocket for their prescription. For alendronate, clopidogrel and pantoprazole, only prescription drug coverage predicted adopter category. Early prescribers of one new drug were not early prescribers of the other new drugs.


CONCLUSIONS
No common group of patients or physicians who were early prescribers or users of all four medications was described.
Kozyrskyj
Anita
A
Faculty of Pharmacy and Medicine, Department of Community Health Sciences and Pediatrics and Child Health, Manitoba Centre for Health Policy, University of Manitoba, 210 Pharmacy Bldg, Winnipeg, MB, Canada. kozyrsk@cc.umanitoba.ca
Raymond
Colette
C
Racher
Amber
A
D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000627:therapeutic use; D000368:Aged; D000369:Aged, 80 and over; D019386:Alendronate / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D000068579:Celecoxib; D000077144:Clopidogrel; D003625:Data Collection; D004059:Diffusion of Innovation; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004363:Drug Utilization / Q000706:statistics & numerical data* / Q000639:trends; D005194:Family Practice / Q000706:statistics & numerical data / Q000639:trends; D005260:Female; D006801:Humans; D007349:Insurance, Health, Reimbursement; D008297:Male; D008350:Manitoba; D008875:Middle Aged; D000077402:Pantoprazole; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data* / Q000639:trends*; D011720:Pyrazoles / Q000627:therapeutic use; D012959:Socioeconomic Factors; D013449:Sulfonamides / Q000627:therapeutic use; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D013997:Time Factors
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D011720:Pyrazoles; D013449:Sulfonamides; D000077144:Clopidogrel; D000077402:Pantoprazole; D000068579:Celecoxib; D013988:Ticlopidine; D019386:Alendronate