Medication utilization in children born preterm in the first two years of life

Objective To compare medications dispensed during the first 2 years in children born preterm and full-term. Study design Retrospective analysis of claims data from a commercial national managed care plan 2008-2019. 329,855 beneficiaries were enrolled from birth through 2 years, of which 25,408 (7.7%) were preterm (<37 weeks). Filled prescription claims and paid amount over 2 years were identified. Results In preterm children, the number of filled prescriptions was 1.4 times and cost was 3.8 times that of full-term children. Number and cost of medications were inversely related to gestational age. Differences peak at 4-9 months and resolve by 19 months after discharge. Palivizumab, ranitidine, albuterol, lansoprazole, budesonide, and prednisolone had the greatest differences in utilization. Conclusion Prescription medication utilization among preterm children under 2 years is driven by palivizumab, anti-reflux, and respiratory medications, despite little evidence regarding efficacy for many medications and concern for harm with certain classes.

Automated summary

This study compared medication dispensing in children born preterm and full-term during the first two years of life. It found that preterm children had a higher number and cost of prescriptions, with differences peaking at 4-9 months and resolving by 19 months after discharge. The utilization of palivizumab, anti-reflux, and respiratory medications drove prescription medication usage among preterm children under 2 years.