Utilization of Pharmacy Claims Data to Evaluate Therapeutic Interchange Programs

Abstract

OBJECTIVE: To gain insight into the accuracy of dosing guidelines and the overall success of a therapeutic' interchange program by analyzing pharmacy claims data. DESIGN: Evaluation of prescribing patterns via retrospective analysis of pharmacy claims data for therapeutic interchange between angiotensin II converting enzyme inhibitors (ACEls). SETTING: A California IPA-model HMO. MAIN OUTCOME MEASURES: Percentage of conversion doses that corresponded with pharmacy and therapeutics (P&T) guidelines variation among actual conversion doses utilized, and number of dosage titrations associated with implementing conversions. RESULTS: The analysis revealed that dosing ratios utilized to convert patients from lisinopril, quinapril, enalapril, and ramipril to benazepril HCI corresponded with P&T guidelines 83%, 78%, 54%, and 26% of the time, respectively. The variance in conversion doses from enalapril and ramipril was significantly greater than from lisinopril and quinapril (p less than O.01). The overall percent...