title: Variation in the use of medicines by ethnicity during 2006/07 in New Zealand: a preliminary analysis.
abstract: OBJECTIVE
  To describe variations in dispensing of specific medication groups by ethnicity in New Zealand, adjusting for health need.
  
  
  METHODS
  Preliminary linkage of dispensings of prescription medicines in 2006/07 to age/disease burden proxies of health need for Maori, Pacific peoples (Pasifika)--who are mostly of Samoan, Tongan, Niuean, or Cook Islands descent--in New Zealand, and non-Maori/non-Pasifika. These disease burden proxies combine differences in prevalence, age, morbidity, and mortality. Variations were disaggregated by patients being first dispensed medicines ('access') versus subsequent dispensings ('persistence').
  
  
  RESULTS
  Initially, overall age-adjusted incidence of 'scripts' (prescriptions dispensed) to Maori was similar to that of non-Maori. There were differences in therapeutic coverage between Maori and Pasifika, for example greater use of asthma medicines in Maori. However, further adjustments linking with disease burden showed marked variance for a number of diseases. Differences in dispensing included areas of high health need such as heart disease, infections, diabetes, mental health and respiratory disease. Maori had 19-37% lower dispensings overall than non-Maori, with a net difference of nearly 1 million scripts. Maori were both less likely to access medicines, and then after first dispensing had fewer subsequent scripts. Patterns for Pasifika appeared similar, although needs-adjusted analysis is awaited for this population.
  
  
  CONCLUSIONS
  Once adjusting for need, there was variable but sizeable differences in medicines dispensed to Maori compared with non-Maori, and likely differences for Pasifika populations. There are however important limitations to this preliminary analysis. Crude and age-standardised metrics may be poor predictors of needs-adjusted gaps in medicines use. In this analysis, solely age-standardised rates tended to underestimate differences once adjusting for burden of disease; future analyses of prescribing patterns should consider better adjusting for disease burden.
authors.forename: Scott
authors.initials: S
authors.lastname: Metcalfe
authors.forename: George
authors.initials: G
authors.lastname: Laking
authors.forename: Jason
authors.initials: J
authors.lastname: Arnold
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D011307:Drug Prescriptions / Q000592:standards / Q000706:statistics & numerical data; D054625:Healthcare Disparities / Q000208:ethnology; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D009520:New Zealand; D011114:Polynesia / Q000208:ethnology; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D055553:Prescription Drugs / Q000627:therapeutic use; D005006:Ethnicity
chemical_list: D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D000928:Antidepressive Agents; D000959:Antihypertensive Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007004:Hypoglycemic Agents; D055553:Prescription Drugs