Trends of outpatient prescription drug utilization in US children, 2002-2010.
OBJECTIVE
To describe trends in outpatient prescription drug utilization in US children and the changes in major areas of pediatric therapeutic use for the years 2002 through 2010.


METHODS
Large prescription databases (the IMS Vector One: National and Total Patient Tracker) were used to examine national drug utilization patterns for the US pediatric population (ages 0-17 years) from 2002 through 2010.


RESULTS
In 2010, a total of 263.6 million prescriptions were dispensed to the US pediatric population, 7% lower than in 2002, while prescriptions dispensed to the adult population increased 22% during the same time. Analysis of pediatric drug utilization trends for the top 12 therapeutic areas in 2010 compared with 2002 showed decreases in systemic antibiotics (-14%), allergies (-61%), pain (-14%), depression (-5%), and cough/cold without expectorant (-42%) prescriptions, whereas asthma (14%), attention-deficit/hyperactivity disorder (46%), and contraceptive (93%) prescriptions increased. In 2010, amoxicillin was the most frequently dispensed prescription in infants (aged 0-23 months) and children (aged 2-11 years). Methylphenidate was the top prescription dispensed to adolescents (aged 12-17 years). Off-label use was identified, particularly for lansoprazole; ~358,000 prescriptions were dispensed in 2010 for infants <1 year old.


CONCLUSIONS
Changes in the patterns of pediatric drug utilization were observed from 2002 to 2010. Changes include a decrease in antibiotic use and an increase in attention-deficit/hyperactivity disorder medication use during the examined time. This article provides an overview of pediatric outpatient drug utilization, which could set the stage for further in-depth analyses.
Office of Surveillance and Epidemiology, Division of Epidemiology II, Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland, USA. grace.chai@fda.hhs.gov
Grace
G
Chai
Laura
L
Governale
Ann W
AW
McMahon
James Phillip
JP
Trinidad
Judy
J
Staffa
Dianne
D
Murphy
D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000627:therapeutic use; D000293:Adolescent; D000553:Ambulatory Care; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy; D000697:Central Nervous System Stimulants / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004363:Drug Utilization / Q000706:statistics & numerical data / Q000639:trends*; D005764:Gastroesophageal Reflux / Q000188:drug therapy; D019538:Health Care Surveys; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D064747:Lansoprazole; D016018:Least-Squares Analysis; D016014:Linear Models; D008774:Methylphenidate / Q000627:therapeutic use; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data / Q000639:trends*; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D014481:United States
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000900:Anti-Bacterial Agents; D000697:Central Nervous System Stimulants; D054328:Proton Pump Inhibitors; D064747:Lansoprazole; D008774:Methylphenidate