PhD Student University of Toronto Leslie Dan Faculty of Pharmacy Toronto, Canada
Background: Diclectin (doxylamine and pyridoxine combination) is an antiemetic authorized in Canada to treat nausea and vomiting of pregnancy (NVP), also known as morning sickness. In January 2018, there was extensive media attention following the daily newspaper Toronto Star in Ontario reporting on Diclectin’s lack of efficacy as detailed in previously unpublished clinical trial data submitted for the regulatory approval process.
Objectives: To understand the impact of media coverage on the utilization of Diclectin in Canada.
Methods: A time-series analysis of monthly dispensing data for Diclectin across Canada from April 2016 to March 2022 was conducted using the IQVIA CompuScript® database. Trends in the total volume of Diclectin dispensed by retail pharmacists in Ontario and across Canada were adjusted for using pregnancy numbers obtained from StatCan birth data. The impact of media coverage in January 2018 on the utilization of Diclectin was assessed with interventional autoregressive integrated moving average modeling for overall rates and stratified by prescriber specialty.
Results: Diclectin utilization decreased significantly by 1.16% (p = 0.0150) in Ontario, while it did not shift significantly (p = 0.0642) across Canada overall. Within Ontario, there was a significant decline of 2.41% (p = 0.0098) in Diclectin utilization among family medicine and general practitioners, who also accounted for 391,722 (63.21%) of 619,720 total Diclectin prescriptions. Among obstetrician-gynecologists in Ontario, there was a non-significant decline of 0.50% (p = 0.2352) in utilization.
Conclusions: Despite garnering nationwide media attention questioning its efficacy, utilization trends of Diclectin were most impacted only in Ontario, while the negative press did not translate to similar shifts in other parts of Canada. This is in line with the media coverage being greatest in Ontario, as the news was first published in the Toronto Star. Our results suggest a lack of other viable options for pregnant individuals suffering from NVP and thus highlight a need for concerted actions for ensuring equitable public access to quality medications.
Acknowledgment: The statements, findings, conclusions, views, and opinions contained and expressed in this brief report are based in part on data obtained under license from the following IQVIA Solutions Canada Inc. information service(s): CompuScript® database. All Rights Reserved. The statements, findings, conclusions, views, and opinions contained and expressed herein are not necessarily those of IQVIA Solutions Canada Inc. or any of its affiliated or subsidiary entities.
