title: Bisphosphonate use in the treatment of Paget's disease of the bone: analysis of claims in a large database.
abstract: This study examines the use of bisphosphonates for treating Paget's disease of the bone through an analysis of drug, dose, and therapy-duration data. Data were obtained from a national, multi-managed care plan claims database (based on claims filed from 1996-2004). Patient eligibility criteria included at least one claim with Paget's disease International Classification of Diseases, Ninth Revision code 731.0, at least one bisphosphonate pharmacy claim, at least six months' continuous enrollment after initiating bisphosphonate therapy (index date), and no more than one claim for osteoporosis. The proportion of patients with bisphosphonate therapy extending beyond the initial recommended treatment regimen (incremental drug use) and associated costs were calculated for each drug. Of 433 patients with Paget's disease receiving bisphosphonate treatment (mean age, 65.0 yr; 64.3% women), 53.1% were prescribed alendronate at the index date; 34.9% and 7.4%, were prescribed risedronate and etidronate, respectively. More than 40% of patients with Paget's disease receiving at least one bisphosphonate were prescribed bisphosphonates beyond the recommended regimen duration at substantial incremental costs.
authors.affiliation: Analytica International, New York City 10016, USA.
authors.forename: Margarita
authors.initials: M
authors.lastname: Dolgitser
authors.forename: Lee
authors.initials: L
authors.lastname: Stern
authors.forename: Laura M
authors.initials: LM
authors.lastname: Katz
authors.forename: John J
authors.initials: JJ
authors.lastname: Doyle
authors.forename: Mohamed
authors.initials: M
authors.lastname: Omar
authors.forename: Margaret
authors.initials: M
authors.lastname: Seton
authors.forename: Kristijan H
authors.initials: KH
authors.lastname: Kahler
mesh_terms: D000368:Aged; D004164:Diphosphonates / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007345:Insurance Claim Review; D008297:Male; D008875:Middle Aged; D010001:Osteitis Deformans / Q000150:complications / Q000188:drug therapy* / Q000191:economics; D017063:Outcome Assessment, Health Care; D014481:United States
chemical_list: D004164:Diphosphonates