title: Actual versus predicted first-year utilization patterns of teriparatide in patients with employer-sponsored health insurance.
abstract: OBJECTIVE
  To characterize first-year utilization patterns of teriparatide derived from a claims database analysis versus predictions from an economic model.
  
  
  METHODS
  Claims data for actual teriparatide utilization were obtained from an integrated administrative database of approximately 3.4 million beneficiaries. A control group included patients with osteoporosis but without the use of teriparatide. An economic model, which relied on first-year market share projections, predicted the utilization of teriparatide from the demographic characteristics of the plan. Predictions were compared to actual utilization for eight health plans within the database.
  
  
  METHODS
  Demographic and clinical characteristics, number of teriparatide patients, and days of teriparatide therapy.
  
  
  RESULTS
  Less than 1% of patients diagnosed with osteoporosis received teriparatide. Teriparatide-treated patients, compared to other patients with osteoporosis, were older and more likely to have experienced a previous fracture or to have received previous osteoporosis pharmacotherapy. For the combined 505 300 lives in the eight plans used for the comparative analysis, there were 134 teriparatide patients; the model predicted 131. For individual plans, the predictions varied in their accuracy. The greatest under-prediction for one plan was 17 patients (40 predicted vs. 57 actual), while the greatest over-prediction was 18 patients (34 predicted vs. 16 actual). For the other 6 plans, the predictions were within four patients of the actual number of teriparatide users. A similar pattern of differences was observed by comparing actual versus predicted days of teriparatide therapy across the eight plans.
  
  
  CONCLUSIONS
  Some clinical details of the actual patient cohorts, such as bone mineral density results, were not available in the database. The comparisons made between the teriparatide model predictions and actual utilization were based on analyses of a single model and do not speak to the broader issue of the accuracy of predictive economic models in general.
  
  
  CONCLUSIONS
  Overall, first-year teriparatide utilization was relatively limited, consistent with model predictions. Predictions for individual plans varied in their accuracy.
authors.affiliation: Eli Lilly and Company, Indianapolis, IN, USA. emeadows@lilly.com
authors.forename: Eric S
authors.initials: ES
authors.lastname: Meadows
authors.forename: Matthew
authors.initials: M
authors.lastname: Rousculp
authors.forename: Alicia C
authors.initials: AC
authors.lastname: Sasser
authors.forename: Howard G
authors.initials: HG
authors.lastname: Birnbaum
authors.forename: Erick
authors.initials: E
authors.lastname: Moyneur
authors.forename: David
authors.initials: D
authors.lastname: Mallet
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Johnston
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D004334:Drug Administration Schedule; D004363:Drug Utilization; D005260:Female; D006801:Humans; D007348:Insurance, Health; D008297:Male; D008875:Middle Aged; D018803:Models, Economic; D010024:Osteoporosis / Q000188:drug therapy*; D011379:Prognosis; D019379:Teriparatide / Q000008:administration & dosage* / Q000191:economics*
chemical_list: D019379:Teriparatide