Racial-ethnic differences in incident olanzapine use after an FDA advisory for patients with schizophrenia

Psychiatr Serv. 2013 Jan;64(1):83-7. doi: 10.1176/appi.ps.201200002.

Abstract

Objective: Prior investigations suggest that olanzapine use declined rapidly after a U.S. Food and Drug Administration (FDA) communication and consensus statement warning of the drug's increased metabolic risks, but whether declines differed by racial-ethnic groups is unknown.

Methods: Changes in olanzapine use over time by race-ethnicity was assessed among 7,901 Florida Medicaid enrollees with schizophrenia.

Results: Prior to the advisory, 57% of second-generation antipsychotic fills among Hispanics were for olanzapine, compared with 40% for whites or blacks (adjusted risk difference [ARD]=.17, 95% confidence interval [CI]=.13-.20). Olanzapine use declined among all racial-ethnic groups. Although Hispanics had greater olanzapine use than whites in each period, the differences in absolute risk were only 3% by the latest study period (ARD=.03, CI=.01-.04).

Conclusions: After the FDA communication and consensus statement were issued, differences in olanzapine use between white and Hispanic enrollees narrowed considerably. Identifying high-use subgroups for targeted delivery of drug safety information may help eliminate any existing differences in prescribing.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Antipsychotic Agents / adverse effects
  • Antipsychotic Agents / metabolism
  • Antipsychotic Agents / therapeutic use*
  • Benzodiazepines / adverse effects
  • Benzodiazepines / metabolism
  • Benzodiazepines / therapeutic use*
  • Black People / statistics & numerical data
  • Confidence Intervals
  • Diabetes Mellitus / chemically induced
  • Florida
  • Hispanic or Latino / statistics & numerical data
  • Humans
  • Hyperlipidemias / chemically induced
  • Medicaid
  • Olanzapine
  • Racial Groups
  • Schizophrenia / drug therapy*
  • Schizophrenia / ethnology*
  • United States
  • United States Food and Drug Administration*
  • White People / statistics & numerical data

Substances

  • Antipsychotic Agents
  • Benzodiazepines
  • Olanzapine