(Updated June 2011)
Prescriptions for menopausal hormone therapy (HT) in the United States dipped slightly in 2010, continuing a slow but steady downward trend seen over the last several years. So indicate the latest data available from the IMS National Prescription Audit Plus™ from IMS Health.
The audit reflects the number of prescriptions filled at the retail level (including refills) in the United States. It does not include compounded HT preparations.
As the graphs below show, the number of prescriptions dispensed has declined each year from 2006 through 2010 for each of the four types of commercial HT products tracked: estrogens, progestogens, estrogen-progestogen combinations, and androgen-estrogen combinations.
The pie charts below show the market share of prescriptions held by the leading products among the three main HT categories: estrogens, progestogens, and estrogen-progestogen combinations. The relative shares of these products have remained very stable over the past 5 years.
There is one notable exception to this downward trend: prescriptions for topical (vaginal) estrogen products for menopausal use. Prescriptions for vaginal estrogens have risen steadily at the same time that prescriptions for HT products overall have fallen.
According to the IMS National Prescription Audit Plus™, the number of prescriptions dispensed for vaginal estrogen products rose from 2.8 million in 20011 to 4.52 million in 2006—a rise of 61% during these years when the use of systemic HT products fell sharply over safety concerns in the wake of the 2002 publication of initial results from the Women’s Health Initiative trial. Dispensed prescriptions for vaginal estrogen products increased further from 4.52 million in 2006 to 5.29 million in 2010—an increase of 17%. The result is that prescriptions for vaginal estrogens rose 89% overall from 2001 to 2010.
While the number of overall HT prescriptions has fallen modestly in each of the last few years, the wholesale sales amount (in dollars) has modestly increased from year to year for each of the three main HT categories (estrogens, progestogens, and estrogen-progestogen combinations), reflecting wholesale price inflation for these products. So indicate the latest available data from IMS National Sales Perspectives™ from IMS Health. In 2010, collective US sales of these products at wholesale prices were as follows:
Combination androgen-estrogen products proved an exception to this trend, as their sales at wholesale prices have dropped substantially in recent years, from $148 million in 2006 to a mere $30 million in 2010.
These data are supplied by IMS Health, a healthcare industry information services company that compiles one of the most complete national-level prescription databases in the United States.
The IMS National Prescription Audit Plus™ captures approximately 70% of all prescriptions in the United States and then uses projection methodology from a stratified and geographically balanced sample to represent 100% market share coverage of US prescriptions dispensed at retail, mail service, long-term care, and managed care outlets.
IMS National Sales Perspectives™ tracks sales activity for all pharmaceutical distribution channels, including major retail food stores and chains, mass merchandisers, independent pharmacies, mail service pharmacies, hospitals, clinics, closed-wall HMOs, long-term care facilities, home health care providers, prisons, and universities. Sales information is compiled from more than 100 pharmaceutical manufacturers and more than 300 wholesaler and chain warehouses.
All data copyright © IMS Health. Used by NAMS with permission.
1. Hersh AL, Stefanick ML, Stafford RS. National use of postmenopausal hormone therapy. Annual trends and response to recent evidence. JAMA 2004;291:47-53.
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