The Effect of Informative Letters on the Prescription and Receipt of Seroquel

Abdul Latif Jameel Poverty Action Lab

Status: Completed

Conditions: Delivery of Health Care; Economics; Health Expenditures; Fraud; Centers for Medicare and Medicaid Services (U.S.)

Treatments: Other: Placebo letter; Other: Initial Informative letter; Other: Followup Informative Letter

Study type: Interventional

Funder types: Other; Other U.S. Federal agency

Identifiers

NCT02467933

JPAL-LETTERS-SEROQUEL

Details and patient eligibility

About

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.

Enrollment: 5,055 patients

Sex: All

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• General care practitioner
• Outlier with respect to the count of Seroquel prescription drug treatments relative to peer group of prescribers in 2013 and 2014
• Outlier with respect to the count of Seroquel 30-day equivalent prescription drug treatments relative to peer group of prescribers in 2013 and 2014

Exclusion criteria

• Deceased

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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5,055 participants in 2 patient groups, including a placebo group

Placebo

Placebo Comparator group

Description:

The placebo arm receives a placebo letter unrelated to Seroquel

Treatment:

Other: Placebo letter

Informative Letter

Experimental group

Description:

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.

Treatment:

Other: Followup Informative Letter

Other: Initial Informative letter