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- Title
Equity in the Receipt of Oseltamivir in the United States During the H1N1 Pandemic.
- Authors
Franklin, Jessica M.; Choudhry, Niteesh K.; Uscher-Pines, Lori; Brill, Gregory; Matlin, Olga S.; Fischer, Michael A.; Schneeweiss, Sebastian; Avorn, Jerry; Brennan, Troyen A.; Shrank, William H.
- Abstract
Objectives. We assessed the relationship between individual characteristics and receipt of oseltamivir (Tamiflu) in the United States during the HI NI pandemic and other flu seasons. Methods. In a cohort of individuals enrolled in pharmacy benefit plans, we used a multivariate logistic regression model to measure associations between subscriber characteristics and filling a prescription for oseltamivir during 3 flu seasons (October 2006-May 2007, October 2007-May 2008, and October 2008- May 2010), In 19 states with county-level influenza rates reported, we controlled for disease burden. Results. Approximately 56 million subscribers throughout the United States were included in 1 or more study periods. During pandemic flu, beneficiaries in the highest income category had 97% greater odds of receiving oseltamivir than those in the lowest category (P<.001). After we controlled for disease burden, subscribers in the 2 highest income categories had 2.18 and 1.72 times the odds of receiving oseltamivir compared with those in the lowest category (P< .001 for both). Conclusions. Income was a stronger predictor of oseltamivir receipt than prevalence of influenza. These findings corroborate concerns about equity of treatment in pandemics, and they call for improved approaches to distributing potentially life-saving treatments.
- Subjects
UNITED States; H1N1 influenza; OSELTAMIVIR; CLUSTER analysis (Statistics); CONFIDENCE intervals; STATISTICAL correlation; HEALTH services accessibility; INCOME; PHARMACEUTICAL services insurance; POPULATION geography; RESEARCH funding; MULTIPLE regression analysis; PREDICTIVE validity; RETROSPECTIVE studies; DESCRIPTIVE statistics; ODDS ratio; PREVENTION; THERAPEUTICS
- Publication
American Journal of Public Health, 2014, Vol 104, Issue 6, p1052
- ISSN
0090-0036
- Publication type
Article
- DOI
10.2105/AJPH.2013.301762