Changes in Pramipexole Utilization after Introduction of the Extended-Release Formulation: A Nationwide Study in Taiwan
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ORIGINAL RESEARCH ARTICLE
Changes in Pramipexole Utilization after Introduction of the Extended‑Release Formulation: A Nationwide Study in Taiwan K. Arnold Chan1,2 · Yu‑Chun Hsieh1 · Shu‑Feng Hsieh1 · Rou‑Shayn Chen3 Accepted: 1 October 2020 © The Author(s) 2020
Abstract Background Real-world impact of extended-release formulations of oral drugs should ideally be evaluated in populationbased health data. Objective To evaluate changes in utilization of the dopamine agonist pramipexole for Parkinson’s disease after the introduction of extended-release (ER) pramipexole in Taiwan. Patients and Methods Source data were derived from National Health Insurance claims. Patients with a diagnosis of Parkinson’s disease and pramipexole prescriptions were identified. Drug use patterns from 2009 through 2011 (only the immediaterelease [IR] formulation was available) and from 2012 through 2017 (both the IR and ER formulations were available) were assessed. Outcomes of interest were levodopa equivalent dose per day (LEDD) and 1-year adherence, as measured by the medication possession ratio (MPR). Results LEDDs associated with pramipexole ER prescriptions were more than twice as large as that associated with pramipexole IR, both in pramipexole used in monotherapy and that used in combination therapy. One-year MPRs for pramipexole ER initiators were all larger than 73% from 2012 through 2016 and 1-year MPRs for pramipexole IR initiators were less than 65% in 2010 and 2011. Conclusion Introduction of pramipexole ER to Taiwan resulted in higher LEDD in prescriptions with pramipexole. Patients with Parkinson’s disease who were initiated on pramipexole ER had better adherence to the medication than those who were prescribed pramipexole IR.
1 Background Evaluation of population-based drug-utilization data could provide insight into whether patients benefit from the best available treatment in the real-world setting. Among the many important topics of drug utilization research, assessing the use of an extended-release (ER) formulation of an oral
Key Points Introduction of extended-release pramipexole to Taiwan resulted in marked increase of its use over the following 5 years, but the concomitant decrease in immediaterelease pramipexole was not substantial over the same period.
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s40801-020-00215-6) contains supplementary material, which is available to authorized users.
Prescriptions with extended-release pramipexole were associated with higher levodopa equivalent dose per day than that for immediate-release pramipexole.
* K. Arnold Chan [email protected]
Patients who were initiated on extended-release pramipexole had better adherence, as measured by medication possession ratio, than those who were prescribed immediate-release pramipexole.
1
Health Data Research Center, National Taiwan University, 33, Linsen South Road, Suite 526, Taipei, Taiwan
2
College of Medicine, National Taiwan University, 1 Jen‑Ai Road, Section
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