35395 Analysis of utilization & trends of spironolactone prescriptions by dermatologists among Medicare Part D patients: 2013-2019

Abstract

Background: Spironolactone is a potassium-sparring diuretic that has gained an increasing role for androgen-mediated dermatologic diseases such as hirsutism and acne due to its antiandrogenic properties. There are limited data on national prescription patterns of spironolactone among dermatologists. Design: A retrospective analysis was conducted using the Medicare Part D Prescriber datasets from 2013-2019. Only data from spironolactone prescriptions made by dermatologists was analyzed. Yearly claims per 100,000 beneficiaries, total drug costs, and total drug supply days were recorded. Average annual growth rate (AAGR) was calculated and trend significance was determined through a linear regression model. Significance was determined apriori at P < .05. Purpose: From 2013-2019, there was a 109% increase in the number of dermatologists prescribing spironolactone to Medicare Part D enrollees. Each year, recipients who were <65 years and located in the South made up the highest proportion of spironolactone use. An increased AAGR with a statistically significant increasing trend was seen for yearly claims per 100,000 beneficiaries (AAGR = 11%, trend: P < .001), total drug costs (AAGR = 11.1%, trend: P = .005) and total drug supply days (AAGR = 20%, trend: P < .001). Conclusion: Spironolactone’s use in dermatology has significantly grown as claims made per 100k beneficiaries and total drug supply days have increased despite rising costs. These findings show the use of spironolactone for androgenic dermatological conditions may be gaining more acceptance among dermatologists, but further studies are warranted.