Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #107217

Junling Wang, PhD, Division of Health Science Administration, Department of Pharmaceutical Sciences, University of Tennessee Collge of Pharmacy, 847 Monroe Avenue, Room 205R, Memphis, TN 38163, 901-448-3601, jwang26@utmem.edu and C. Daniel Mullins, PhD, Department of Pharmaceutical health Services Research, University of Maryland, School of Pharmacy, 515 W. Lombard Street, 2nd Floor, Baltimore, MD 21201.

Objectives: Prior results documented racial/ethnic disparities in access to new medicines, the current analysis examines whether there are racial or ethnic disparities in the utilization of new, essential prescription drugs.

Methodology: The main data source was Medical Expenditure Panel Survey (1996-2001), which provided information on patient characteristics and, for each prescribed medicines, drug name, NDC and payment sources. Drugs were considered “new” if approved less than six years ago at the time of survey data collection. They were considered essential if at least four out of five experts considered them “essential”. A negative binomial model was used to test disparities across racial/ethnic groups when controlling for other confounders; the dependent variable was number of new, essential prescribed medicines obtained; independent variables were dummy variables for racial/ethnic groups; generosity (percentages of drug cost paid by health insurance); interaction terms between generosity and dummy variables for race/ethnicity; age; gender; marital status; education; and dummy variables for census regions, metropolitan statistical area, poverty status, and self-perceived health status. Sensitivity analyses were performed using variable definitions for the number of years post-launch that a drug is considered new and using relaxed criterion for essential drugs.

Results: Among 47,115 prescription users, 31,853 were non-Hispanic whites, 5,904 were non-Hispanic blacks, and 7,337 were white Hispanics. According to the descriptive analysis, the difference in the mean numbers of new, essential medicines between non-Hispanic whites (1.02) and non-Hispanic blacks (0.94) was not significant but that between non-Hispanic whites (1.02) and white Hispanics (0.70) was significant. The negative binomial model showed that the numbers of new, essential prescribed medicines were 13-39% lower (depending on the criterion for defining new drugs) among non-Hispanic blacks than among non-Hispanic whites; the numbers among white Hispanics were 9-25% lower than among non-Hispanic whites. These differences were generally not statistically significant. The generosity and self-perceived worse health status had positive effects on the use of new, essential drugs. Interaction terms between race/ethnicity and generosity were not significant. Sensitivity analysis reported similar results.

Conclusions: In contrast to documented racial/ethnic disparities in the use of new medicines, racial disparities in the use of new, essential drugs are not confirmed while ethnic disparities can be largely accounted for by socioeconomic factors. The generosity of drug insurance coverage and self-perceived worse health status are positively correlated with the use of new, essential drugs. The correlations between the generosity and the use are fairly consistent across racial/ethnic groups.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• Understand modeling techniques with the dependent variables being count variables and each study subject observed more than once;
• Illustrate the procedure for analyzing the causes for racial/ethnic disparities;
• Devise implications for policy and practice based on status of racial/ethnic disparities in the use of new, essential drugs.

Keywords: Prescription Drug Use Patterns, Minorities

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.