Comparative effectiveness of generic and brand-name medication use: A database study of US health insurance claims

Abstract Background Although self-reported questionnaires are widely employed in epidemiologic studies, their validity has not been sufficiently assessed. The aim of this study was to evaluate the validity of a self-reported questionnaire on medication use by comparison with health insurance claims and to identify individual determinants of discordance.Methods Participants were 2,720 community-dwellers aged 37 to 78 years from the Tsuruoka Metabolomics Cohort Study. Information on lifestyle and medications was collected through a questionnaire. Sensitivity and specificity were determined using health insurance claims from November 2014 to March 2016, which were used as a standard. Potential determinants of discordance were assessed by multivariable logistic regression.Results The self-reported questionnaire on medication use showed high validity. Sensitivity and specificity were 0.95 (95% CI:0.93-0.96) and 0.94 (0.93-0.95) for antihypertensives, 0.94 (0.91-0.97) and 0.98 (0.98-0.99) for diabetes medications, 0.84 (0.82-0.87) and 0.96 (0.95-0.97) for dyslipidemia medications, respectively. Males without high education were found to be associated with discordant reporting, especially those with medication use for dyslipidemia.Conclusions In this population-based study, we found that the self-reported questionnaire on medication use was a valid measure of true medication use. Sensitivity for dyslipidemia medications was lower than those for the other medications. Type of medication, gender and education influenced discordance in self-reporting.

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Erratum to “Validity Assessment of Self-reported Medication Use for Hypertension, Diabetes, and Dyslipidemia in a Pharmacoepidemiologic Study by Comparison With Health Insurance Claims” [J Epidemiol (2020) doi:10.2188/jea.JE20200089. Epub ahead of print.]

Journal of Epidemiology ◽

10.2188/jea.je20210109 ◽

2021 ◽

Author(s):

Minako Matsumoto ◽

Sei Harada ◽

Miho Iida ◽

Suzuka Kato ◽

Mizuki Sata ◽

...

Keyword(s):

Health Insurance ◽

Medication Use ◽

Insurance Claims ◽

Validity Assessment ◽

Health Insurance Claims

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Serum uric acid control for prevention of gout flare in patients with asymptomatic hyperuricaemia: a retrospective cohort study of health insurance claims and medical check-up data in Japan

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-220439 ◽

2021 ◽

pp. annrheumdis-2021-220439

Author(s):

Ruriko Koto ◽

Akihiro Nakajima ◽

Hideki Horiuchi ◽

Hisashi Yamanaka

Keyword(s):

Uric Acid ◽

Cohort Study ◽

Health Insurance ◽

Serum Uric Acid ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Disease Status ◽

Insurance Claims ◽

Health Insurance Claims ◽

Gout Flare

ObjectivesIn patients with gout, treating to target serum uric acid levels (sUA) of ≤6.0 mg/dL is universally recommended to prevent gout flare. However, there is no consensus on asymptomatic hyperuricaemia. Using Japanese health insurance claims data, we explored potential benefits of sUA control for preventing gout flare in subjects with asymptomatic hyperuricaemia.MethodsThis retrospective cohort study analysed the JMDC Claims Database from April 2012 through June 2019. Subjects with sUA ≥8.0 mg/dL were identified, and disease status (prescriptions for urate-lowering therapy (ULT), occurrence of gout flare, sUA) was investigated for 1 year. Time to first onset and incidence rate of gout flare were determined by disease status subgroups for 2 years or more. The relationship between gout flare and sUA control was assessed using multivariable analysis.ResultsThe analysis population was 19 261 subjects who met eligibility criteria. We found fewer occurrences of gout flare, for both gout and asymptomatic hyperuricaemia, in patients who achieved sUA ≤6.0 mg/dL with ULT than in patients whose sUA remained >6.0 mg/dL or who were not receiving ULT. In particular, analysis by a Cox proportional-hazard model for time to first gout flare indicated that the HR was lowest, at 0.45 (95% CI 0.27 to 0.76), in subjects with asymptomatic hyperuricaemia on ULT (5.0<sUA ≤ 6.0 mg/dL), compared with untreated subjects (sUA ≥8.0 mg/dL).ConclusionsOccurrences of gout flare were reduced by controlling sUA at ≤6.0 mg/dL in subjects with asymptomatic hyperuricaemia as well as in those with gout.Trial registration numberUMIN000039985.

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Prevalence of gout and asymptomatic hyperuricemia in the pediatric population: a cross-sectional study of a Japanese health insurance database

BMC Pediatrics ◽

10.1186/s12887-020-02379-0 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Shuichi Ito ◽

Tomoko Torii ◽

Akihiro Nakajima ◽

Takeshi Iijima ◽

Hiroshi Murano ◽

...

Keyword(s):

Uric Acid ◽

Health Insurance ◽

Pediatric Population ◽

Gouty Arthritis ◽

Cross Sectional Study ◽

Sectional Study ◽

Insurance Claims ◽

Cross Sectional ◽

Total Prevalence ◽

Health Insurance Claims

Abstract Background Although gout is rare in children, chronic sustained hyperuricemia can lead to monosodium urate deposits progressing to gout, just as in adults. This study assessed prevalence and characteristics of gout and asymptomatic hyperuricemia, and incidence of gouty arthritis in the pediatric population, using data from Japanese health insurance claims. The diagnosis and treatment of pediatric gout and hyperuricemia were analyzed, and specific characteristics of those patients were assessed. Since Japanese guidelines recommend treatment with uric acid lowering drugs for asymptomatic hyperuricemia as well as for gout, these data were also used to investigate the real-world use of uric acid lowering drugs in a pediatric population. Methods This cross-sectional study was based on a 2016–2017 Japanese health insurance claims database, one of the largest epidemiology claims databases available in Japan, which included 356,790 males and 339,487 females 0–18 years of age. Outcomes were measured for prevalence, patient characteristics, treatment with uric acid lowering drugs for gout and asymptomatic hyperuricemia, and prevalence and incidence of gouty arthritis. Because uric acid can be elevated by some forms of chemotherapy, data from patients under treatment for malignancies were excluded from consideration. Results Total prevalence of gout and asymptomatic hyperuricemia in 0–18 year-olds was 0.040% (276/696,277 patients), with gout prevalence at 0.007% (48/696,277) and asymptomatic hyperuricemia at 0.033% (228/696,277). Prevalence of gout and asymptomatic hyperuricemia was highest in adolescent males, at 0.135% (176/130,823). The most common comorbidities for gout and asymptomatic hyperuricemia were metabolic syndrome at 42.8% (118/276) and kidney disease at 34.8% (96/276). Of the patients diagnosed with gout or asymptomatic hyperuricemia, 35.1% (97/276) were treated with uric acid lowering drugs. Gouty arthritis developed in 43.8% (21/48) of gout patients during the study, at an incidence of 0.65 flares/person-year. Conclusions Even the pediatric population could be affected by asymptomatic hyperuricemia, gout, and gouty arthritis, and uric acid lowering drugs are being used in this population even though those drugs have not been approved for pediatric indications. Such off-label use may indicate a potential need for therapeutic agents in this population. Trial registration UMIN000036029.

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