Patterns of Prescription WeightLoss Drug Use

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Patterns of Prescription Weight-Loss Drug Use

• Endocrinologic and Metabolic Drugs Advisory
  Committee Meeting
• Rockville, Maryland
• September 8, 2004
• Laura A. Governale, Pharm.D., MBA
• Drug Utilization Specialist Team Leader
• Division of Surveillance, Research and
• Communication Support
• Office of Drug Safety/CDER

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Topics on Prescription Weight-Loss Drug Use

• Prescription Weight-Loss Drugs
• Dexfenfluramine
• Sibutramine
• Orlistat
• Amphetamine Congeners
• Prescribing Trends
• Patient Demographics
• Not covered in this analysis
• Over-the-Counter Weight-Loss Drugs
• Nutritional Supplements

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Topics on Prescription Weight-Loss Drug Use

• Prescription Weight-Loss Drugs
• Dexfenfluramine
• Sibutramine
• Orlistat
• Amphetamine Congeners
• Prescribing Trends
• Patient Demographics
• Not covered in this analysis
• Over-the-Counter Weight-Loss Drugs
• Nutritional Supplements

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Data Sources

• IMS Health, National Prescription Audit Plus
  (NPA Plus)
• Measures the retail outflow of prescriptions
  from pharmacies to consumers via prescriptions
• Includes chain, independent, mass
  merchandisers, food stores with pharmacies,
  mail-order, and long-term care pharmacies
• IMS Health, National Disease and Therapeutic
  Index (NDTI)
• Survey of roughly 3,000 office-based physician
  practice patterns in the continental U.S.
• Data include profiles and trends of diagnoses,
  patients and treatment patterns

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Prescribing Trends for Prescription Weight-Loss
Drugs

• Data Source IMS Health, National Prescription
  Audit Plus (NPA Plus)
• Total Number of Prescriptions Dispensed, 1966
  2003
• Method of Payment for Prescription Weight-Loss
  Drugs, 1999 2003

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IMS Health, National Prescription Audit Plus7,
Years 1997 2003, Extracted March 2004, NPA
Plus Therapeutic Category Report, Years December
1966 -1996, Hard Copy Books
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IMS Health, National Prescription Audit Plus7,
Years 1997 2003, Extracted March 2004, NPA
Plus Therapeutic Category Report, Years December
1966 -1996, Hard Copy Books
8
IMS Health, National Prescription Audit Plus7,
Years 1997 2003, Extracted March 2004, NPA
Plus Therapeutic Category Report, Years December
1966 -1996, Hard Copy Books
9
IMS Health, National Prescription Audit Plus7,
Years 1999 2003, Extracted August 2004
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Patient Demographics

• IMS Health, National Disease and Therapeutic
  Index (NDTI)
• Principle Diagnoses Associated with Prescription
  Weight-Loss Drug Use
• Gender Distribution
• Age Distribution
• Race Distribution

Prescription Weight-Loss Drugs phentermine,
orlistat, sibutramine, phendimetrazine,
diethylpropion, benzphetamine, mazindol,
fenfluramine, and dexfenfluramine
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(No Transcript)
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IMS Health, National Disease and Therapeutic
Index, Years 1998-2003, Extracted September 2004
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IMS Health, National Disease and Therapeutic
Index, Years 1998-2003, Extracted September 2004
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IMS Health, National Disease and Therapeutic
Index, Years 1998-2003, Extracted September 2004
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IMS Health, National Disease and Therapeutic
Index, Years 1998-2003, Extracted September 2004
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Limitations

• NPA Plus? provides only limited demographic
  information on prescription use
• NDTI? is based on a sample size of 2000 - 3000
  office-based physicians. The small sample size
  can make these data projections unstable,
  particularly when use is not highly prevalent.
• Data not be generalizable to all obese patients
  since only patients seen by physicians in
  office-based settings are represented
• Due to the limitations in sampling in this
  database, any perceived trends must be
  interpreted with caution.

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Conclusions

• Drug use for prescription weight-loss drugs has
  fluctuated over the last 38 years and has
  declined in recent years.
• Cash payment remains an important mechanism for
  payment for these drugs.
• The primary users of these products are Caucasian
  women between the ages of 18-44.

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Acknowledgements

• Gerald DalPan, M.D., MHS, Division of
  Surveillance, Research and Communication Support
• Eric Colman, M.D., Division of Metabolic and
  Endocrine Drug Products
• Bruce Stadel, M.D., Division of Metabolic and
  Endocrine Drug Products
• Anne Trontell, M.D., MPH, Office of Drug Safety