Abstract
Objectives
We analyzed the impact of implementing a preauthorization policy for Rosiglitazone (an anti-diabetic drug) use on the eligibility requirements (treatment initiation and discontinuation) and patients' HbA1c levels.
Methods
We compared treatment patterns of diabetic patients prior to and after an implementation of a preauthorization policy for Rosiglitazone use. Data were obtained from the Maccabi Healthcare Services' (the second largest HMO in Israel) registry of diabetic patients. We compared adherence to eligibility criteria in a group of patients who received Rosiglitazone without preauthorization (N=1362) and patients who received the medication with preauthorization (N=824). The criteria for receiving Rosiglitazone in both groups were identical and included prior medication [experienced patients who received drug from the sulphonylurea class in combination with Metformin for at least a three months period], and laboratory criterion [HbA1c levels higher than 8% during the past three months]. Treatment should be continued only if within three months from treatment initiation, the patient acquired at least three packages of Rosiglitazone and a decrease of >0.8% in HbA1c values was observed.
Results
Implementing preauthorization policy increased the fulfillment of the eligibility criteria (medication and laboratory) for drug use by 41% [from 25% of patients without preauthorization to 35% with preauthorization (p<0.001)]. With regard to meeting the requirements for treatment continuation after a three month period, there was an increase of only 6.4% in the fulfillment of both requirements (from 37.6% to 40.0% prior and after preauthorization, respectively). The average decrease in patients' HbA1c levels was 0.6% and was similar in both patients with and without preauthorization.
Conclusions
Implementing preauthorization for Rosigitazone resulted in an increase in meeting the requirements for treatment initiation and a marginal change in treatment continuation criteria, but this increase was insufficient to achieve HbA1c target levels. However, patients' health was not negatively affected by this policy.
We analyzed the impact of implementing a preauthorization policy for Rosiglitazone (an anti-diabetic drug) use on the eligibility requirements (treatment initiation and discontinuation) and patients' HbA1c levels.
Methods
We compared treatment patterns of diabetic patients prior to and after an implementation of a preauthorization policy for Rosiglitazone use. Data were obtained from the Maccabi Healthcare Services' (the second largest HMO in Israel) registry of diabetic patients. We compared adherence to eligibility criteria in a group of patients who received Rosiglitazone without preauthorization (N=1362) and patients who received the medication with preauthorization (N=824). The criteria for receiving Rosiglitazone in both groups were identical and included prior medication [experienced patients who received drug from the sulphonylurea class in combination with Metformin for at least a three months period], and laboratory criterion [HbA1c levels higher than 8% during the past three months]. Treatment should be continued only if within three months from treatment initiation, the patient acquired at least three packages of Rosiglitazone and a decrease of >0.8% in HbA1c values was observed.
Results
Implementing preauthorization policy increased the fulfillment of the eligibility criteria (medication and laboratory) for drug use by 41% [from 25% of patients without preauthorization to 35% with preauthorization (p<0.001)]. With regard to meeting the requirements for treatment continuation after a three month period, there was an increase of only 6.4% in the fulfillment of both requirements (from 37.6% to 40.0% prior and after preauthorization, respectively). The average decrease in patients' HbA1c levels was 0.6% and was similar in both patients with and without preauthorization.
Conclusions
Implementing preauthorization for Rosigitazone resulted in an increase in meeting the requirements for treatment initiation and a marginal change in treatment continuation criteria, but this increase was insufficient to achieve HbA1c target levels. However, patients' health was not negatively affected by this policy.
| Original language | English |
|---|---|
| Pages (from-to) | A484 |
| Journal | Value in Health |
| Volume | 14 |
| Issue number | 7 |
| DOIs | |
| State | Published - Nov 2011 |