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Hydroxyurea use among children with sickle cell anemia

Sarah L Reeves1,2, Hannah K Jary1, Jennifer P Gondhi1

  • 1Susan B Meister Child Health Evaluation and Research Center, Department of Pediatrics, University of Michigan, Ann Arbor, Michigan.

Pediatric Blood & Cancer
|March 23, 2019
PubMed

Insights

Hydroxyurea adherence is low for children with sickle cell anemia (SCA), with only 18% receiving adequate medication days. Strategies are needed to improve hydroxyurea use in pediatric SCA patients.

Area of Science:

  • Pediatric Hematology
  • Public Health
  • Pharmacotherapy

Background:

  • Sickle cell anemia (SCA) is a serious inherited blood disorder.
  • Hydroxyurea is a recommended treatment for pediatric SCA.
  • Adherence to hydroxyurea therapy is crucial for managing SCA complications.

Purpose of the Study:

  • To assess hydroxyurea dispensing patterns in children with SCA.
  • To evaluate adherence to hydroxyurea therapy based on dispensed days.
  • To identify variations in hydroxyurea use across states.

Main Methods:

  • Retrospective analysis of administrative claims data.
  • Study population: 7963 children (ages 1-17) with SCA enrolled in Medicaid in six states (2005-2012).
  • Hydroxyurea dispensing data summarized by state and year.

Main Results:

  • A total of 22,424 person-years were analyzed.
  • Among children receiving hydroxyurea for >30 days, only 18% received ≥300 days of supply.
  • Significant state-level variation in hydroxyurea dispensing was observed.

Conclusions:

  • Current hydroxyurea adherence among pediatric SCA patients is suboptimal.
  • Updated recommendations emphasize offering hydroxyurea to all children with SCA.
  • Development of targeted strategies is necessary to improve hydroxyurea adherence in this population.

Keywords:
Medicaidadministrative claimshydroxyureasickle cell anemia

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