Use of select medications prior to duloxetine initiation among commercially-insured patients

Figures & data

Table

Medication classes	Specific medications
Antidepressants	Selective serotonin reuptake inhibitors, tricyclic antidepressants, serotonin-norepinephrine reuptake inhibitors, other antidepressants (bupropion, trazodone, mirtazapine, maprotiline, nefazodone)
Anticonvulsants	Gabapentin, pregabalin, clonazepam, carbamazepine, topiramate, phenytoin, divalproex, zonisamide, lamotrigine, oxcarbazepine, primidone
Opioids	Oxycodone, tramadol, codeine, hydrocodone, propoxyphene, meperidine, butorphanol, fentanyl, pentazocine, oxymorphone, morphine, levorphanol, hydromorphone, methadone
Nonsteroidal anti-inflammatory drugs	Celecoxib, rofecoxib, valdecoxib, ibuprofen, naproxen, indomethacin, diclofenac, nabumetone, etodolac, meloxicam, sulindac, piroxicam, oxaprozin, ketoprofen, tolmetin, ketorolac tromethamine, diclofenac
Muscle relaxants	Baclofen, carisoprodol, chlorphenesin, chlorzoxazone, cyclobenzaprine, dantrolene, diazepam, metaxalone, methocarbamol, orphenadrine

Table 1 Characteristics of duloxetine initiators

	Overall			2009
	2007	2008	2009	MDD	GAD	DPNP	FM	OA	LBP
Patients (n)	56,845	44,838	65,840	19,546	5,764	2,334	15,362	12,317	27,781
Proportion among all initiators (%)				29.7	8.8	3.5	23.3	18.7	42.2
Age categories (%)	*	*
18–34 years	15.5	14.7	16.2	19.7	27.5	2.1	11.8	3.4	12.5
35–44 years	23.1	21.8	22.6	23.3	27.0	10.5	21.7	10.6	21.3
45–54 years	32.7	33.2	31.8	31.5	27.3	32.2	35.7	35.3	34.3
55–64 years	28.8	30.3	29.4	25.5	18.2	55.1	30.9	50.7	31.8
Mean age (±SD)	46.7 (11.2)	47.1* (11.1)	46.6 (11.3)	45.2 (11.7)	42.3 (11.9)	53.9 (7.8)	47.9 (10.3)	53.1 (8.1)	48.0 (10.5)
Female (%)	74.5*	74.8	75.1	74.0	71.6	58.1	87.0	77.3	74.0
Region (%)	*	*
Northeast	8.5	7.8	8.6	10.0	10.5	8.2	7.9	8.3	7.7
North central	25.0	27.6	27.9	29.1	27.9	26.4	28.7	27.9	27.0
South	52.4	48.0	49.0	43.2	49.0	52.7	48.6	50.3	51.0
West	13.5	16.1	14.3	17.3	12.3	12.6	14.6	13.2	14.0
Unknown	0.6	0.6	0.3	0.4	0.2	0.1	0.3	0.3	0.3
Health plan type (%)	*	*
Comprehensive	4.6	4.6	2.9	2.9	2.0	4.7	2.8	4.0	3.4
Health maintenance organization	17.0	16.0	15.4	16.8	14.5	16.2	15.0	15.2	14.5
Point of service	11.3	13.3	8.7	9.6	7.5	8.6	8.5	8.7	8.6
Preferred provider organization	61.8	59.1	65.9	64.3	68.4	64.6	66.9	65.5	66.6
Other	4.0	4.3	4.8	4.6	4.9	3.9	4.4	4.3	4.6
Missing	1.4	2.6	2.3	1.9	2.7	1.9	2.4	2.4	2.3

Notes:

* Statistically significant at P < 0.05 compared with 2009 using Chi-square test for categorical variables (age, category, gender, health plan type, and region) and Student’s t-test for continuous variable (mean age).

Abbreviations: DPNP, diabetic peripheral neuropathic pain; FM, fibromyalgia; GAD, generalized anxiety disorder; LBP, low back pain; SD, standard deviation; MDD, major depressive disorder; OA, osteoarthritis.

Figure 1 Use of select medications during the 12 months prior to duloxetine initiation across disease states.

Figure 2 Use of select medications during the 12 months prior to duloxetine initiation among patients with major depressive disorder or generalized anxiety disorder.

Figure 3 Use of select medications during the 12 months prior to duloxetine initiation among patients with pain indications.

Figure 4 Use of select medications over the 12 months prior to duloxetine initiation over time.