(038) Adherence Patterns And Costs For Flibanserin: A Single Practice Experience

Abstract

Abstract Introduction Flibanserin is a partial serotonin agonist/antagonist and has been approved for use in premenopausal females with hypoactive sexual desire disorder (HSDD). This medication has been used off-label in males and postmenopausal females in the management of low libido. There is a paucity of data on prescribing patterns for both on and off-label use. Objective This study aims to evaluate costs and refill patterns for flibanserin and to determine if adherence was affected by insurance coverage or off-label use. Methods This was a retrospective review of online pharmacy records for patients from one sexual medicine practice that were prescribed flibanserin. De-identified patient information was collected and included age, gender, menopause status, refill information, and out-of-pocket cost. All prescriptions for premenopausal and perimenopausal females met criteria for on-label use and all prescriptions for men and postmenopausal females were considered off-label. Results Data was available from 109 patients. Forty-nine premenopausal/perimenopausal women were included in the on-label group and 60 patients were assigned to the off-label group as they were males (n=31) or postmenopausal females (n=29). Twelve percent of patients never filled their prescription, 28% filled it once, and 60% filled it ≥2 times. There was no significant difference in the percentage of patients with 0, 1 and ≥2 prescriptions filled between the on and off-label groups (12%, 24%, 63% vs. 12%, 32%, 57%). Out-of-pocket cost of flibanserin without insurance coverage was $99 for a 30-day supply or $199 for a 90-day supply. Twenty-one percent of patients had insurance coverage and their cost was $0 or $20 for a 30-day supply. The average out-of-pocket cost was $67 per 30-day supply (SD=$34). There was no significant difference in the percentage of patients with 0, 1 and ≥2 prescriptions filled between patients with and without insurance coverage (0%, 24%, 76% vs. 3%, 34%, 64%). The percentage of patients with insurance coverage did not significantly differ between those with on and off-label prescriptions (25% vs. 19%). Conclusions This study is the first to explore medication adherence and cost of flibanserin. Sixty percent of patients filled ≥2 prescriptions and refill rates were not affected by off-label use or insurance coverage. Only 21% of patients had insurance coverage for the medication. The limitations of the study include a small sample size from one clinic. The results of this study will help clinicians to recognize costs and adherence with on and off-label use of flibanserin. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Sprout Pharmaceuticals, Absorption Pharmaceuticals.