Improving Hydroxyurea Uptake in Children: Results from a Provider Incentive Program in a Large Metropolitan Health...

Area of Science:

• Hematology
• Pediatric Medicine
• Public Health Interventions

Background:

• Sickle cell disease (SCD) is a genetic blood disorder affecting millions globally.
• Hydroxyurea is a proven, safe, and effective oral medication for managing SCD in children by increasing fetal hemoglobin.
• Suboptimal utilization and adherence to hydroxyurea therapy persist among pediatric SCD patients.

Purpose of the Study:

• To assess the impact of a provider incentive program on hydroxyurea prescription rates in children with SCD.
• To evaluate secondary outcomes including medication adherence, acute care utilization, and associated costs in a Medicaid-enrolled pediatric population.

Main Methods:

• A pre-post comparison design was employed within a large metropolitan health system.
• The primary outcome measured was the rate of active hydroxyurea prescriptions.
• Secondary outcomes included hydroxyurea fills, adherence, and acute care utilization and costs for Medicaid beneficiaries.

Main Results:

• The provider incentive program led to significant increases in active hydroxyurea prescriptions over time.
• Participating providers showed greater increases in prescribing hydroxyurea.
• Significant improvements were observed in hydroxyurea fills among children enrolled in Medicaid.

Conclusions:

• Provider incentive programs can effectively enhance hydroxyurea utilization for pediatric sickle cell disease.
• These interventions may improve prescribing practices and counseling, leading to better treatment adherence.
• Findings support the implementation of similar strategies to optimize SCD management in children.