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Medication utilization in children born preterm in the first two years of life

Jonathan C Levin1,2,3,4, Andrew L Beam5, Kathe P Fox6

  • 1Computational Health Informatics Program, Boston Children's Hospital, Boston, MA, USA. jonathan.levin@childrens.harvard.edu.

Journal of Perinatology : Official Journal of the California Perinatal Association
|February 6, 2021
PubMed

Insights

Preterm infants receive significantly more prescription medications and incur higher costs than full-term infants during their first two years. This medication use, particularly for respiratory and reflux conditions, is linked to gestational age and raises safety concerns.

Area of Science:

  • Pediatric pharmacology
  • Neonatal care
  • Health services research

Background:

  • Infants born preterm often require specialized medical care due to immature organ systems.
  • Understanding medication use in this population is crucial for optimizing health outcomes and managing healthcare costs.

Purpose of the Study:

  • To compare the types and costs of medications dispensed to preterm versus full-term infants during the first two years of life.
  • To identify specific medication classes with differential utilization between these groups.

Main Methods:

  • Retrospective analysis of commercial claims data from 2008-2019.
  • Inclusion of beneficiaries enrolled from birth through two years, identifying 25,408 preterm infants (<37 weeks gestation).
  • Analysis of filled prescription claims and associated costs over the two-year period.

Main Results:

  • Preterm infants had 1.4 times more filled prescriptions and 3.8 times higher medication costs compared to full-term infants.
  • Medication number and cost were inversely related to gestational age.
  • Significant utilization differences were observed for palivizumab, ranitidine, albuterol, lansoprazole, budesonide, and prednisolone, peaking at 4-9 months post-discharge.

Conclusions:

  • Prescription medication use in preterm infants under two years is substantial, driven by specific agents like palivizumab and medications for reflux and respiratory issues.
  • Concerns exist regarding the efficacy and potential harm of certain medication classes used in this vulnerable population.
  • Further research is needed to evaluate the evidence base for commonly prescribed medications in preterm infants.
Abstract

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