Changes in Dispensing of Acid Blockers to U.S. Children: 2016-2023
Kao-Ping Chua, Sijia He, Rena M. ContiOBJECTIVES
To evaluate changes in dispensing of acid blockers, defined as H2 receptor antagonists and proton pump inhibitors, to U.S. children aged 0-18 years after ranitidine was recalled in late September 2019 and after the COVID-19 pandemic began.
METHODS
We analyzed the 2016-2023 IQVIA Longitudinal Prescription Database, which includes prescriptions dispensed from 92% of U.S. retail pharmacies. Using an interrupted time series design, we assessed for level and slope changes in the monthly number of dispensed acid blocker prescriptions to children in October 2019 (month after ranitidine recall) and April 2020 (month after pandemic began). We repeated analyses among infants aged 0-1 years and older children aged 2-18 years.
RESULTS
In October 2019, there was a level decrease of 55,809 acid blocker prescriptions (95% CI: -92,038, -19,580), representing a 11.0% decline relative to the predicted value in January 2016 (intercept). There was no level change in April 2020 but there was a slope increase (11,749 prescriptions/month, 95% CI: 595, 22,903). Despite this increase, acid blocker dispensing in December 2023 was 10.9% lower than predicted had pre-October 2019 trends continued. Among infants and older children, dispensing was 25.5% and 4.7% lower than predicted, respectively.
CONCLUSIONS
Acid blocker dispensing to U.S. children declined sharply after the ranitidine recall, illustrating the power of drug recalls to affect prescribing decisions in children. After the COVID-19 pandemic began, acid blocker dispensing recovered to a greater degree in older children compared to infants. Future research should investigate the reasons for these diverging trends.