How Quickly Do Physicians Adopt New Drugs?

The Case of Second-Generation Antipsychotics

Published In: Psychiatric Services, v. 64, no. 4, Apr. 2013, p. 324-330

Posted on RAND.org on April 01, 2013

by Haiden A. Huskamp, A. James O'Malley, Marcela Horvitz-Lennon, Anne Levine Taub, Ernst R. Berndt, Julie M Donohue

Read More

Access further information on this document at American Psychiatric Association

This article was published outside of RAND. The full text of the article can be found at the link above.

OBJECTIVE: The authors examined physician adoption of second-generation antipsychotic medications and identified physician-level factors associated with early adoption. METHODS: The authors estimated Cox proportional-hazards models of time to adoption of nine second-generation antipsychotics by 30,369 physicians who prescribed antipsychotics between 1996 and 2008, when the drugs were first introduced, and analyzed the total number of agents prescribed during that time. The models were adjusted for physicians' specialty, demographic characteristics, education and training, practice setting, and prescribing volume. Data were from IMS Xponent, which captures over 70% of all prescriptions filled in the United States, and the American Medical Association Physician Masterfile. RESULTS: On average, physicians waited two or more years before prescribing new second-generation antipsychotics, but there was substantial heterogeneity across products in time to adoption. General practitioners were much slower than psychiatrists to adopt second-generation antipsychotics (hazard ratios (HRs) range .10−.35), and solo practitioners were slower than group practitioners to adopt most products (HR range .77−.89). Physicians with the highest antipsychotic-prescribing volume adopted second-generation antipsychotics much faster than physicians with the lowest volume (HR range .15−.39). Psychiatrists tended to prescribe a broader set of antipsychotics (median=6) than general practitioners and neurologists (median=2) and pediatricians (median=1). CONCLUSIONS: As policy makers search for ways to control rapid health spending growth, understanding the factors that influence physician adoption of new medications will be crucial in the efforts to maximize the value of care received by individuals with mental disorders as well as to improve medication safety.

This report is part of the RAND Corporation external publication series. Many RAND studies are published in peer-reviewed scholarly journals, as chapters in commercial books, or as documents published by other organizations.

The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.