Demus Timothy, Getzenberg Robert H, Nieder Alan M
Columbia University Division of Urology at Mount Sinai Medical Center, Miami Beach, Florida.
Veru Inc., Miami, Florida.
Urol Pract. 2023 Jan;10(1):90-97. doi: 10.1097/UPJ.0000000000000362. Epub 2022 Dec 19.
The availability of oral therapies for advanced prostate cancer allows urologists to continue to care for their patients who develop castration resistance. We compared the prescribing practices of urologists and medical oncologists in treating this patient population.
The Medicare Part D Prescribers data sets were utilized to identify urologists and medical oncologists who prescribed enzalutamide and/or abiraterone from 2013 to 2019. Each physician was assigned to one of 2 groups: enzalutamide prescriber (physicians that wrote more 30-day prescriptions for enzalutamide than abiraterone) or abiraterone prescriber (opposite). We ran a generalized linear regression to determine factors influencing prescribing preference.
In 2019, 4,664 physicians met our inclusion criteria: 23.4% (1,090/4,664) urologists and 76.6% (3,574/4,664) medical oncologists. Urologists were more likely to be enzalutamide prescribers (OR 4.91, CI 4.22-5.74, < .001) and this held in all regions. Urologists with greater than 60 prescriptions of either drug were not shown to be enzalutamide prescribers (OR 1.18, CI 0.83-1.66, = .349); 37.9% (5,702/15,062) of abiraterone fills by urologists were for generic compared to 62.5% (57,949/92,741) of abiraterone fills by medical oncologists.
There are dramatic prescribing differences between urologists and medical oncologists. A greater understanding of these differences is a health care imperative.
晚期前列腺癌口服疗法的出现使泌尿科医生能够继续照料出现去势抵抗的患者。我们比较了泌尿科医生和肿瘤内科医生在治疗这一患者群体时的处方习惯。
利用医疗保险D部分处方者数据集，确定2013年至2019年期间开具恩杂鲁胺和/或阿比特龙处方的泌尿科医生和肿瘤内科医生。每位医生被分配到以下两组之一：恩杂鲁胺处方者（开具恩杂鲁胺30天处方多于阿比特龙的医生）或阿比特龙处方者（情况相反）。我们进行了广义线性回归，以确定影响处方偏好的因素。
2019年，4664名医生符合我们的纳入标准：23.4%（1090/4664）为泌尿科医生，76.6%（3574/4664）为肿瘤内科医生。泌尿科医生更有可能是恩杂鲁胺处方者（比值比4.91，置信区间4.22 - 5.74；P <.001），且在所有地区均如此。开具两种药物中任一种超过60张处方的泌尿科医生并非恩杂鲁胺处方者（比值比1.18，置信区间0.83 - 1.66；P = 0.349）；泌尿科医生开具的阿比特龙处方中，37.9%（5702/15062）为非专利药，而肿瘤内科医生开具的阿比特龙处方中这一比例为62.
