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| Name | Class |
|---|---|
| Centers for Medicare and Medicaid Services | FED |
| General Services Administration (GSA) | FED |
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Abusive prescribing exposes patients to unnecessary health risks and results in wasteful public expenditures. This study will evaluate an innovative approach to fighting abusive prescription: sending letters to suspected inappropriate prescribers warning them that they are outliers compared to their peers and have been flagged for review. The study will target high prescribers of Seroquel (Quetiapine), an atypical antipsychotic. Using claims data, the investigators will assess the effect of the letters on prescribing of Seroquel, receipt of Seroquel by patients, substitution behavior by prescribers and patients, and health outcomes of patients.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Placebo | Placebo Comparator | The placebo arm receives a placebo letter unrelated to Seroquel |
|
| Informative Letter | Experimental | The interventional arm prescribers receive an initial informative letter (called a comparative billing report or peer activity report) followed by 2 followup informative letters at approximately 3 month intervals. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Placebo letter | Other | The placebo letter describes a new rule in Medicare that requires prescribers to enroll in Medicare |
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| Measure | Description | Time Frame |
|---|---|---|
| 30-day equivalent prescribing of Seroquel treatments | The prescribing of Seroquel over the 9 months following the initial sending of the letters. Prescribing is defined as the total "days supply" of Seroquel attributed to the prescriber, expressed in "30-day equivalents" i.e. divided by 30. | 9 months |
| Measure | Description | Time Frame |
|---|---|---|
| 30-day equivalent prescribing of Seroquel treatments | 3 months | |
| 30-day equivalent prescribing of Seroquel treatments | 6 months | |
| 30-day equivalent prescribing of Seroquel treatments |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Adam Sacarny, PhD | Columbia University | Principal Investigator |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 30073273 | Derived | Sacarny A, Barnett ML, Le J, Tetkoski F, Yokum D, Agrawal S. Effect of Peer Comparison Letters for High-Volume Primary Care Prescribers of Quetiapine in Older and Disabled Adults: A Randomized Clinical Trial. JAMA Psychiatry. 2018 Oct 1;75(10):1003-1011. doi: 10.1001/jamapsychiatry.2018.1867. |
| Label | URL |
|---|---|
| American Economic Association Randomized Controlled Trials Registry Entry | View source |
| ID | Type | URL | Comment |
|---|---|---|---|
| 449 | Study Protocol | View IPD |
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| Initial Informative letter | Other | The intervention is a letter that describes the Seroquel prescribing activity of the individual in comparison to a peer group of similar prescribers. It highlights the fact that the prescriber's activity is highly unlike her peers. |
|
| Followup Informative Letter | Other | The followup informative letter is identical to the initial informative letter except it provides an update on more recent prescribing rather than a description of earlier prescribing. |
|
| 1 year |
Study protocol archived on American Economic Association Social Science Registry page. |
| 448 | Statistical Analysis Plan | View IPD | Pre-specified analysis plan archived on American Economic Association Social Science Registry page. Final version prior to unblinding: Version 2.0 (March 5, 2016) |