Prescribing Trends for Vaginal Estrogen: What Role Do Urogynecology and Reconstructive Pelvic Surgery Urologists...

To evaluate the impact of Urogynecology and Reconstructive Pelvic Surgery (URPS) board certification on prescribing trends of vaginal estrogen (VE) by urologists participating in Medicare Part D.

The Medicare Part D Prescriber dataset was queried from 2016 to 2018 to identify urologists who made VE claims. Board certification status was obtained from the American Board of Urology website. Urologist gender was obtained from the National Plan & Provider Enumeration System NPI registry. Parametric statistics were used to analyze claims and expenditure trends.

From 2016 to 2018, 2367 urologists were identified with VE claims, including 272 board-certified in URPS. URPS urologists had more claims per prescriber than non-URPS urologists for all years (2016: 42.9 vs 26.7, P <.01; 2017: 42 vs 27.4, P <.01; 2018: 30.1 vs 23.9, P <.01). Female urologists had more claims per prescriber than male urologists in 2016 (36.9 vs 26.5, P <.01) and 2017 (37.9 vs 26.8, P <.01). On multivariate analysis, URPS fellowship (β = 8.6, 95% CI 6.3-10.8, P <.01) and female gender of prescriber (β = 4.9, 95% CI 3.1-6.7, P <.01) were significant predictors for making more VE claims. Within URPS urologists, there was no significant difference in average VE claims between male and female prescribers.

Both URPS and female urologists made more VE claims per prescriber than non-URPS urologists. These findings may reflect referral patterns or reveal discrepancies in how urologists treat genitourinary syndrome of menopause.

N/A, as this study is not a clinical trial.