Evidence map›Paper›PMID 28400458›Full record

Observational studyBMJ open2017

What drives the prescribing of growth hormone preparations in England? Prices versus patient preferences.

Stephen R Chapman, Raymond W Fitzpatrick, Mohammed I Aladul

Abstract readObservational Study
In one paragraph

Observational study in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Trial
  2. Article
  3. Article
  4. Article
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Stephen R ChapmanSchool of Pharmacy, Keele University, Newcastle-under-Lyme, Staffordshire, UK.
Raymond W FitzpatrickSchool of Pharmacy, Keele University, Newcastle-under-Lyme, Staffordshire, UK.
Mohammed I AladulSchool of Pharmacy, Keele University, Newcastle-under-Lyme, Staffordshire, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe patent expiry of a number of biological medicines and the advent of biosimilars raised the expectations of healthcare commissioners that biosimilars would reduce the high cost of these medicines and produce potential savings to the NHS. We aimed to examine the prescribing pattern of different growth hormone preparations (ready to use and reconstitution requiring) in primary and secondary care in England to determine relative rates of decrease or increase and identify the possible factors influencing prescribing following the introduction of biosimilar growth hormone in 2008.

designLongitudinal observational study. SETTING AND DATA SOURCES: Primary care prescribing cost and volume data was derived from the NHS business services authority website, and for secondary care from the DEFINE database, between April 2011 and December 2015. OUTCOMES: Quarterly prescribing analysis to examine trends and measure the relationship between usage and price.

resultsExpenditure and usage of growth hormone in primary care decreased by 17.91% and 7.29%, respectively, whereas expenditure and usage in secondary care increased by 68.41% and 100%, respectively, between April 2011 and December 2015. The usage of reconstitution requiring products significantly declined in primary care (R²=0.9292) and slightly increased in use in secondary care (R²=0.139). In contrast, the usage of ready-to-use products significantly increased in use in primary (R²=0.7526) and secondary care (R²=0.9633), respectively. Weak or no correlation existed between the usage and price of growth hormone preparations in primary and secondary care.

conclusionsThe price of growth hormone products was not the key factor influencing the prescribing of the biological medicines. The main driver for specific product selection was the ease of use and the number of steps in dose preparation. Prescribers appear to be taking into account patient preferences rather than cost in their prescribing decisions.

Indexed as

Drug CostsPatient PreferencePrimary Health CareSecondary Health CareBiosimilar PharmaceuticalsCommerceDatabases, FactualEnglandHealth ExpendituresHuman Growth HormoneHumansPractice Patterns, Physicians'Recombinant ProteinsRetrospective StudiesState MedicineBiosimilar PharmaceuticalsHuman Growth HormoneRecombinant ProteinsEPIDEMIOLOGYHEALTH SERVICES ADMINISTRATION & MANAGEMENTTHERAPEUTICS

Identifiers

PMID28400458
PMCPMC5541334

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.