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Nitroprusside, Isoproterenol Prescribing Drops With Price Rise

Decrease in absolute number of patients treated from 2012 to 2015 with major increase in price

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THURSDAY, Aug. 10, 2017 (HealthDay News) -- Increases in the price of nitroprusside and isoproterenol correlated with reductions in their use, according to a letter to the editor published online Aug. 9 in the New England Journal of Medicine.

Umesh N. Khot, M.D., from the Cleveland Clinic, and colleagues examined the impact of price increases on physician prescribing for nitroprusside or isoproterenol using data from 47 hospitals in the Vizient (formerly University HealthSystem Consortium) database. Nitroglycerin and dobutamine, which had stable pricing during that period, served as comparators.

The researchers found that the absolute number of patients treated with nitroprusside or isoproterenol decreased by 53 and 35 percent, respectively, from 2012 to 2015. Per 1,000 inpatients per hospital, there was a 46 and 40 percent decrease in the number of patients treated with nitroprusside and isoproterenol, respectively (both P < 0.001). During the same period, the absolute number of patients treated with nitroglycerin and dobutamine increased by 118 and 7 percent, respectively. The number of patients treated with nitroglycerin and dobutamine per 1,000 inpatients per hospital increased by 89 percent (P < 0.001) and 4 percent (P = 0.74), respectively. Over time, there were increases in the difference in the rate of utilization per 1,000 inpatients per hospital between nitroprusside and nitroglycerin and between isoproterenol and dobutamine (both P < 0.001).

"These findings refute the claim that price increases do not reduce patients' access to these medications," the authors write.

One author disclosed financial ties to AstraZeneca.

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