Topical ophthalmic fourth-generation fluoroquinolones: Appropriate use and cost considerations.
OBJECTIVE
The utilization and refill rates of topical ophthalmic fourth-generation fluoroquinolones among physicians, as well as the associated costs, were studied.


METHODS
A large data set of retrospective pharmacy prescription claims was obtained from multiple plans, including commercial managed care organizations, Medicaid, and Medicare. The data included the number and cost of all new and refill prescriptions for six months for gatifloxacin 0.3% and moxifloxacin 0.5% by physician specialty. New prescription and refill data were also analyzed from a state Medicaid plan to determine if similar trends existed.


RESULTS
Primary care physicians wrote approximately 7,000 (7.7%) gatifloxacin and 84,000 (92.3%) moxifloxacin prescriptions, with pediatricians accounting for 4,000 (5.1%) gatifloxacin and 75,000 (94.9%) moxifloxacin prescriptions. Eye care physicians accounted for a similar amount of prescriptions for each antibiotic during the same period. The total cost of prescriptions for all primary care practitioners was approximately $170,000 for gatifloxacin and $2.5 million for moxifloxacin; prescriptions written by pediatricians accounted for $110,000 for gatifloxacin and $2.2 million for moxifloxacin.


CONCLUSIONS
Prescription drug claims from payers using pharmacy benefit management companies during a six-month period indicated that the numbers of prescriptions written for gatifloxacin and moxifloxacin were similar among eye care physicians, but primary care physicians wrote a greater number of prescriptions for moxifloxacin. Analysis of claims to a Medicaid database revealed an increase in the prescriptions written by primary care physicians for moxifloxacin after its addition to the drug formulary.
Fiscella
Richard G
RG
Department of Pharmacy Practice, University of Illinois at Chicago, IL 60612, USA. fisc@uic.edu
Lewis
Charles C
CC
Jensen
Michael K
MK
D000890:Anti-Infective Agents / Q000191:economics* / Q000627:therapeutic use*; D001372:Aza Compounds / Q000191:economics* / Q000627:therapeutic use*; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D024841:Fluoroquinolones / Q000191:economics* / Q000627:therapeutic use*; D000077734:Gatifloxacin; D006801:Humans; D008484:Medicaid; D006278:Medicare; D000077266:Moxifloxacin; D009883:Ophthalmic Solutions / Q000191:economics* / Q000627:therapeutic use*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011804:Quinolines / Q000191:economics* / Q000627:therapeutic use*; D012189:Retrospective Studies; D014481:United States; D014600:Utilization Review
D000890:Anti-Infective Agents; D001372:Aza Compounds; D024841:Fluoroquinolones; D009883:Ophthalmic Solutions; D011804:Quinolines; D000077734:Gatifloxacin; D000077266:Moxifloxacin