OBJECTIVES: Limited information is available regarding the prevalence and utilization trends of prescription medications among adults diagnosed with Sickle Cell Disease (SCD). This study aimed to examine the prevalence and medication utilization trends among adults with SCD in the United States, including overall changes since the release of SCD treatment guidelines in 2014. The analysis was stratified by patient demographics.

METHODS: This retrospective study utilized Optum’s de-identified Clinformatics® Data Mart database to examine individuals diagnosed with SCD between January 1, 2010, and December 31, 2018. The study population included individuals with at least one inpatient or two outpatient International Classification of Diseases diagnosis claims for SCD during the study period. Overall prevalence and changes in medication utilization over time were assessed using Joinpoint regression to calculate annual percent changes (APCs) and average annual percent change (AAPC). Stratified time trends were evaluated by patient age, sex, race/ethnicity, and region.

RESULTS: Over the 8-year study period, 8,459 individuals with SCD were identified. Most patients were between the age groups of 26-35 years old (20.7%) and ≥65 years old (20.6%). The majority of the study population was female (62.2%). Throughout the study period, 18.3% of the population filled prescriptions for hydroxyurea without significant changes in AAPC. Regarding pain management, approximately 69.4% and 39.4% of the study population were treated with opiate agonists and non-steroidal anti-inflammatory drugs (NSAIDs), with significant average annual increases of 3.5% (p=0.013) and 8.2% (p<0.001), respectively. Annual hydroxyurea utilization increased significantly before the release of SCD treatment guidelines in 2014 (2013-2018 APC 6.7%, p=0.015).

CONCLUSIONS: Medication utilization increased over the entire study period for hydroxyurea, tramadol, amoxicillin-clavulanate, opiate agonists, aminopenicillins, and NSAIDs. Significant increases in medication utilization occurred before the release of SCD treatment guidelines in 2014. However, there is still a need for improvement in the prophylactic utilization of hydroxyurea.