Evolution of postmenopausal hormone therapy between 2002 and 2009.

Area of Science:

• Endocrinology
• Pharmacology
• Public Health

Background:

• The Women's Health Initiative (WHI) results prompted a significant decrease in postmenopausal hormone therapy (HT) utilization.
• Treatment guidelines were subsequently updated, advocating for the lowest effective HT dose for the shortest duration.

Purpose of the Study:

• To analyze national trends in prescription claims for postmenopausal 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 HT 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.
• While low-dose and transdermal formulations saw increased proportional use, they constituted only about 25% of total claims by 2009.