How Informed is the Physician's Off-label Choice?

Last Modified

Creator

Bongu, Srihita
- Affiliation: College of Arts and Sciences, Department of Economics

Abstract

To the best of our knowledge, there is no literature at this point in time which indicates how heavily the physician considers the evolving story of clinical support behind each off-label use of a drug. According to previous studies, off-label prescriptions, or any FDA unapproved use for an approved drug, comprise over 30% of all prescriptions by physicians in the United States. Though the FDA currently bans promotion of drugs for off-label uses, a physician is free to prescribe the choice that maximizes their patient’s health. In this paper, we use prescription level data from the Medical Expenditure Panel Survey (MEPS) from 2007 to 2011. We first determine whether each prescription was an on-label or off-label, and then match the off-label indications to their associated clinical support via diagnosis (ICD-9) code. Using an alternative-specific conditional logistic regression, we estimate how the level of clinical support found in the Merck Manual, an online medical textbook, affects the probability of off-label choice being prescribed for a specific condition. Our research thus gives important insight for regulatory bodies into whether or not physicians are prescribing drugs in a manner that improves public health overall. For a ban lift on off-label promotion to be productive, physicians in the present regulatory environment need to be prescribing alternatives that maximize patient utility.

Date of publication

Keyword

DOI

Resource type

Rights statement

Note

Advisor

Degree

Academic concentration

Honors level

Degree granting institution

Graduation year

Language

Relations

Thumbnail	Title	Date Uploaded	Visibility	Actions
	2017_Bongu.pdf	2019-05-17	Public	Download