title: Impact of access restrictions on varenicline utilization.
abstract: OBJECTIVE
  To assess the impact of access restrictions on varenicline utilization.
  
  
  METHODS
  Employer-sponsored health plans contributing to the MarketScan Commercial Claims and Encounters Database were categorized according to 2009 varenicline access restrictions: no coverage; prior authorization; smoking cessation program requirement; no restrictions. The cohort comprised all adults continuously enrolled in plans during 2009. Each restriction cohort was compared with the no restrictions cohort using descriptive analyses. Data were assessed using logistic regression; demographic and clinical characteristics were covariates.
  
  
  RESULTS
  In this study (no coverage, n = 454,419; prior authorization, n = 171,530; smoking cessation program, n = 108,181; no restrictions, n = 607,389), compared with the no restrictions cohort, the odds of treatment were 71% lower (odds ratio: 0.29; 95% CI: 0.26, 0.31) in the smoking cessation program cohort (p < 0.001) and 80% lower (odds ratio: 0.20; 95% CI: 0.19, 0.22) in the prior authorization cohort (p < 0.001).
  
  
  CONCLUSIONS
  Access restrictions were associated with significantly lower odds for varenicline utilization.
authors.affiliation: Pfizer Inc, 235 East 42nd Street, NY 10017, USA.
authors.forename: Aaron
authors.initials: A
authors.lastname: Galaznik
authors.forename: Katherine
authors.initials: K
authors.lastname: Cappell
authors.forename: Leslie
authors.initials: L
authors.lastname: Montejano
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Makinson
authors.forename: Kelly H
authors.initials: KH
authors.lastname: Zou
authors.forename: Gregory
authors.initials: G
authors.lastname: Lenhart
mesh_terms: D000328:Adult; D001552:Benzazepines / Q000191:economics / Q000627:therapeutic use*; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D006264:Health Benefit Plans, Employee / Q000191:economics; D006801:Humans; D019458:Insurance Coverage / Q000191:economics*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D018722:Nicotinic Agonists / Q000191:economics / Q000627:therapeutic use*; D011810:Quinoxalines / Q000191:economics / Q000627:therapeutic use*; D012189:Retrospective Studies; D016540:Smoking Cessation / Q000191:economics / Q000379:methods*; D000068580:Varenicline
chemical_list: D001552:Benzazepines; D018722:Nicotinic Agonists; D011810:Quinoxalines; D000068580:Varenicline