title: Prescribing patterns for topical retinoids: analyses of 15 years of data from the national ambulatory medical care survey.
abstract: OBJECTIVE
  To examine the prescribing patterns of topical retinoids in the United States.
  
  
  METHODS
  A retrospective, cross-sectional study was employed. Data from the National Ambulatory Medical Care Survey (1990-2004) were used. The impact of patient diagnosis of acne and other covariates on the probability of getting a retinoid prescription was examined using weighted multivariate logistic regression models.
  
  
  RESULTS
  Among the national cohort of patients aged 10 years and older (number of patient visits = 11.7 billion), 41.5 million patients received a topical retinoid prescription. In the retinoid cohort, more than 70% of patients had a diagnosis for acne vulgaris. Diagnosis of acne vulgaris was the strongest predictor of getting a retinoid prescription after controlling for other covariates (OR: 43.39; 95% CI: 32.44, 58.02).
  
  
  CONCLUSIONS
  Requiring prior authorization for topical retinoids for all age groups seems unwarranted and may not be cost-beneficial for the managed care organizations based on these and previous findings.
authors.affiliation: Center for Medication Use, Policy, and Economics, University of Michigan, Ann Arbor, Michigan 48109-1065, USA. rbalkris@umich.edu
authors.forename: Rajesh
authors.initials: R
authors.lastname: Balkrishnan
authors.forename: Monali J
authors.initials: MJ
authors.lastname: Bhosle
authors.forename: Fabian
authors.initials: F
authors.lastname: Camacho
authors.forename: Alan B
authors.initials: AB
authors.lastname: Fleischer
authors.forename: Steven R
authors.initials: SR
authors.lastname: Feldman
mesh_terms: D000152:Acne Vulgaris / Q000175:diagnosis* / Q000188:drug therapy*; D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000379:methods; D016001:Confidence Intervals; D003362:Cost-Benefit Analysis; D003430:Cross-Sectional Studies; D016527:Drug Costs; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D019538:Health Care Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010818:Practice Patterns, Physicians' / Q000639:trends; D012176:Retinoids / Q000191:economics / Q000627:therapeutic use*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D012176:Retinoids