title: Prescription refills and healthcare costs associated with topical metronidazole in Medicaid enrolled patients with rosacea.
abstract: BACKGROUND
  Refill adherence to medications and healthcare costs are important factors to consider while making informed decisions regarding the treatment of rosacea patients.
  
  
  OBJECTIVE
  The objective of this study was to examine predictors of number of refills related to topical metronidazole and total healthcare costs in rosacea patients.
  
  
  METHODS
  This study utilized a longitudinal cohort design and followed rosacea patients enrolled in North Carolina Medicaid and who were prescribed at least one study medication (topical metronidazole, adapalene, azelaic acid, permethrin, and sulfacetamide). Patients' demographic characteristics, number of metronidazole refills, and different components of healthcare costs were examined.
  
  
  RESULTS
  Out of the total 2587 rosacea patients, the majority (approximately 69%, n=1771) had one or more prescriptions for topical metronidazole. Most of the patients in this study were white (73%). After controlling for other variables, increasing age was associated with a higher number of metronidazole refills and healthcare costs (both p<0.001). Compared with white patients, African American patients had a significantly lower number of metronidazole refills (p<0.001). Compared with white patients, African American patients and 'other' races were associated with an 8.6% and 10.3% decrease in total healthcare costs respectively (both p<0.001). An increase in the number of metronidazole refills was not associated with an increase in healthcare costs.
  
  
  CONCLUSIONS
  Patients' race is significantly associated with the number of topical metronidazole refills. Patients' healthcare costs increased with increasing age and charges paid for prescriptions. Topical metronidazole seems to be an economically feasible treatment option for Medicaid-enrolled patients with rosacea.
authors.affiliation: Division of Pharmacy Practice and Administration, Ohio State University, Columbus, OH 43210, USA.
authors.forename: Sujata S
authors.initials: SS
authors.lastname: Jayawant
authors.forename: Steven R
authors.initials: SR
authors.lastname: Feldman
authors.forename: Fabian T
authors.initials: FT
authors.lastname: Camacho
authors.forename: Brad
authors.initials: B
authors.lastname: Yentzer
authors.forename: Rajesh
authors.initials: R
authors.lastname: Balkrishnan
mesh_terms: D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000368:Aged; D000890:Anti-Infective Agents / Q000191:economics / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007223:Infant; D008297:Male; D008484:Medicaid; D008795:Metronidazole / Q000191:economics / Q000627:therapeutic use*; D008875:Middle Aged; D012393:Rosacea / Q000188:drug therapy* / Q000191:economics; D014481:United States; D055815:Young Adult; D016903:Drug Monitoring
chemical_list: D000890:Anti-Infective Agents; D008795:Metronidazole