• Myron Zhang, Jonathan I Silverberg, and Benjamin H Kaffenberger.
• Department of Internal Medicine, Division of Dermatology, The Ohio State University Wexner Medical Center, Columbus, Ohio.
• J. Am. Acad. Dermatol. 2017 Sep 1; 77 (3): 448-455.e2.

BackgroundPrescription patterns for acne/rosacea medications have not been described in the Medicare population, and comparisons across specialties are lacking.ObjectiveTo describe the medications used for treating acne/rosacea in the Medicare population and evaluate differences in costs between specialties.MethodsA cross-sectional study was performed of the 2008 and 2010 Centers for Medicare and Medicaid Services Prescription Drug Profiles, which contains 100% of Medicare part D claims.ResultsTopical antibiotics accounted for 63% of all prescriptions. Patients ≥65 years utilized more oral tetracycline-class antibiotics and less topical retinoids. Specialists prescribed brand name drugs for the most common topical retinoids and most common topical antibiotics more frequently than family medicine/internal medicine (FM/IM) physicians by 6%-7%. Topical retinoids prescribed by specialists were, on average, $18-$20 more in total cost and $2-$3 more in patient cost than the same types of prescriptions from FM/IM physicians per 30-day supply. Specialists (60%) and IM physicians (56%) prescribed over twice the rate of branded doxycycline than FM doctors did (27%). The total and patient costs for tetracycline-class antibiotics were higher from specialists ($18 and $4 more, respectively) and IM physicians ($3 and $1 more, respectively) than they were from FM physicians.LimitationsThe data might contain rare prescriptions used for conditions other than acne/rosacea, and suppression algorithms might underestimate the number of specialist brand name prescriptions.ConclusionCosts of prescriptions for acne/rosacea from specialists are higher than those from primary care physicians and could be reduced by choosing generic and less expensive options.Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

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