Abstract
Objective: To examine off-label use and costs of antihypertensive drugs in children by using a national sample of prescription claims. Methods: We conducted a cross-sectional study using the 2002 Medstat MarketScan Database, a national sample of outpatient prescription claims of children ≤18 years old enrolled in private, employer-sponsored health plans. Our main outcomes were off-label use of antihypertensive drugs by patient age and costs of antihypertensives calculated as mean cost per child per 30-day fill. Results: One half of the index antihypertensive prescription claims were off label, based on minimum age criteria. Boys were more likely (56%) than girls (46%) to be prescribed off-label antihypertensives (P < .001). Children aged ≥12 years were more likely to be prescribed off-label antihypertensives (53%) compared with children aged ≤5 (46%) and 6-11 years (42%; P < .001). Off-label use varied significantly by class of antihypertensive drugs (P < .001). Overall, off-label antihypertensives were significantly more expensive than on-label antihypertensives. Conclusions: Despite availability of often less expensive on-label alternatives for the same class of antihypertensive drugs, off-label antihypertensive drugs were prescribed frequently in children. These findings underscore the potential clinical and economic implications of common off-label prescribing, for children, their parents, physicians, and payers.
Original language | English (US) |
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Pages (from-to) | 299-303 |
Number of pages | 5 |
Journal | Ambulatory Pediatrics |
Volume | 7 |
Issue number | 4 |
DOIs | |
State | Published - Jul 2007 |
Funding
This study was supported by the National Institute of Child Health and Human Development, grant T32 HD07534-05 (Dr Esther Y. Yoon, MD, MPH).
Keywords
- Food and Drug Administration
- antihypertensive drugs
- children
- hypertension
- off label
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health