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Evolution of postmenopausal hormone therapy between 2002 and 2009
Bruce Ettinger1, Sharon M Wang, R Scott Leslie
1University of California, San Francisco, CA, USA. doc.ettinger@gmail.com
Menopause (New York, N.Y.)
|December 31, 2011
Summary
Postmenopausal hormone therapy use significantly declined after 2002, with a greater than 70% reduction by 2009. Low-dose oral and transdermal formulations saw increased use, though still represented only a quarter of claims.
Area of Science:
- Reproductive Medicine
- Pharmacology
- Public Health
Background:
- The Women's Health Initiative (WHI) results led to a significant decrease in postmenopausal hormone therapy (HT) use.
- Treatment guidelines were subsequently updated, recommending HT at the lowest effective dose for the shortest duration.
Purpose of the Study:
- To analyze national trends in prescription claims for oral and transdermal hormone therapy from 2002 to 2009.
- To assess changes in hormone therapy administration routes, dosages, and prescribing patterns.
Main Methods:
- Retrospective analysis of pharmacy claims data from MedImpact Healthcare Systems Inc.
- Inclusion criteria: women with claims for oral or transdermal hormone therapy.
- Data analyzed for trends in claims, route, dose, and physician specialty.
Main Results:
- Total hormone therapy claims decreased by over 70% from 2002 to 2009.
- Proportion of low-dose oral claims quadrupled; standard/high-dose claims decreased by 30%.
- Transdermal formulation claims more than doubled, with low-dose transdermal claims increasing tenfold. Obstetrician/gynecologists favored transdermal routes.
Conclusions:
- A sustained decrease in hormone therapy claims occurred post-WHI.
- Proportional use of low-dose oral and transdermal formulations increased.
- By 2009, low-dose formulations constituted approximately 25% of total hormone therapy claims.
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