title: Actions following adverse drug events - how do these influence uptake and utilisation of newer and/or similar medications?
abstract: BACKGROUND
  Over the last decade, actions following some adverse drug events received major publicity. This study investigated changes in usage patterns of medications in Australia following two examples - rofecoxib market withdrawal (2004) and warnings about jaw necrosis following bisphosphonates (2007).
  
  
  METHODS
  Dispensing data for COX-2 inhibitors (2000-2008) and anti-osteoporosis medications (2003-2012) were obtained from the Australian Pharmaceutical Benefits Scheme database. For bisphosphonates, data on Australian marketing expenditures were purchased from Cegedim(R).
  
  
  RESULTS
  For COX-2 inhibitors, celecoxib dispensing halved after rofecoxib withdrawal, but meloxicam dispensing increased by 60 %. When lumiracoxib was introduced (2006) there was uptake of prescribing at a faster rate than meloxicam in 2002, its first year of use. For bisphosphonates, alendronate had highest use at the time of the warnings (8.3 DDD/1000/day), dropping to 4.9 DDD/1000/day by 2012. In contrast, risedronate use rose 2007-2012 from 4.1 to 4.9 DDD/1000/day. There was 49 % increase in reported annual expenditure on detailing for risedronate from 2007 to 2008 (to AUD$7.3 million) and only 29 % increase for alendronate (to AUD$3.1 million).
  
  
  CONCLUSIONS
  The rapid uptake of prescribing of lumiracoxib and increased use of meloxicam flagged a concern, especially after rofecoxib withdrawal due to safety issues. Bisphosphonates are useful drugs, however the dramatic rise in expenditure on detailing, followed by a rise in utilisation of risedronate could suggest that adverse publicity triggered a marketing response. These examples highlight the importance of tracking utilisation of medication classes in real time, using different data as needed, to ensure that due caution is exercised (and quick intervention provided if needed) for medications in the same class.
authors.affiliation: School of Pharmacy, The University of Queensland, Brisbane, QLD, 4072, Australia. nbarozzi@gmail.com.|Healthy 4Life, PO Box 41, 4009, Basel, Switzerland. nbarozzi@gmail.com.
authors.forename: Nadia
authors.initials: N
authors.lastname: Barozzi
authors.affiliation: Schools of Population Health and Human Movement Studies, The University of Queensland, Brisbane, QLD, 4072, Australia. geeske.peeters@monash.edu.
authors.forename: G M E E Geeske
authors.initials: GM
authors.lastname: Peeters
authors.affiliation: School of Pharmacy, The University of Queensland, Brisbane, QLD, 4072, Australia. s.tett@uq.edu.au.
authors.forename: Susan E
authors.initials: SE
authors.lastname: Tett
mesh_terms: D000368:Aged; D001315:Australia; D050071:Bone Density Conservation Agents / Q000191:economics / Q000627:therapeutic use; D000068579:Celecoxib / Q000191:economics / Q000627:therapeutic use; D052246:Cyclooxygenase 2 Inhibitors / Q000191:economics / Q000627:therapeutic use; D004164:Diphosphonates / Q000191:economics / Q000627:therapeutic use; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D006801:Humans; D007783:Lactones / Q000191:economics / Q000627:therapeutic use; D055118:Medication Adherence; D000077239:Meloxicam; D010024:Osteoporosis / Q000188:drug therapy; D013450:Sulfones / Q000191:economics / Q000627:therapeutic use; D013843:Thiazines / Q000191:economics / Q000627:therapeutic use; D013844:Thiazoles / Q000191:economics / Q000627:therapeutic use
chemical_list: D050071:Bone Density Conservation Agents; D052246:Cyclooxygenase 2 Inhibitors; D004164:Diphosphonates; D007783:Lactones; D013450:Sulfones; D013843:Thiazines; D013844:Thiazoles; C116926:rofecoxib; D000068579:Celecoxib; D000077239:Meloxicam