WO2003042886A2 - System and methods for generating physician profiles concerning prescription therapy practices with self-adaptive predictive model - Google Patents
System and methods for generating physician profiles concerning prescription therapy practices with self-adaptive predictive model Download PDFInfo
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- WO2003042886A2 WO2003042886A2 PCT/US2001/043900 US0143900W WO03042886A2 WO 2003042886 A2 WO2003042886 A2 WO 2003042886A2 US 0143900 W US0143900 W US 0143900W WO 03042886 A2 WO03042886 A2 WO 03042886A2
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Definitions
- the invention relates to systems and methods for analyzing prescription claim histories for physicians, and creating profiles of the prescription therapies of such physicians.
- Pharmaceutical sales representatives typically determine a territory call plan based on information about physicians in their respective coverage areas, and the range of pharmaceutical products that such physicians typically prescribe. This information may include the specialty of the physician, the physician's response to promotional efforts, the physician's ranking in the pharmaceutical product's market share, the physician's ranking in total market volume, and the physician's ranking in the pharmaceutical product's prescription volume. Based on observed patterns with respect to this information, further qualities about physicians have been successfully modeled such as "new product early adopter,” which refers to a physician who tends to prescribe a new product soon after it becomes available, or "brand loyalist,” which refers to a physician who continues to prescribe a specific branded drug, even in the face of competitive drug availability.
- a continuous variable such as New Therapy Start share or Continued Therapy share
- the dependent variable may be the probability of the occurrence of an event relevant to the prescription therapy practices of a physician, e.g., a change in market volume of a particular prescription product.
- An important feature of this statistical analysis is the predictive effect of the variables, i.e., the extent to which one variable influences the outcome of another variable, such as how a change in New Therapy Start share affects the market share of a product.
- These continuous variables may be used to predict physicians' prescribing behavior using, for example, logistic regression models, which are known in the art.
- An object of the present invention is to provide a technique for analyzing the prescription practices of multiple physicians over a given period of time. Another object of the present invention is to provide prescription activity analysis tools which can assist pharmaceutical sales representatives in understanding the prescription practices of physicians.
- a further object of the present invention is to provide a technique for estimating the probability of the occurrence of certain events relevant to the prescribing practices of the physicians.
- a still further object of the present invention is to provide a technique for converting continuous variables into categorical variables for use in a predictive model of physicians' prescribing behavior.
- Yet another object of the present invention is provide a technique for optimizing the number of categorical variable levels to ensure the highest degree of predictive accuracy.
- Data is received by the system for analysis, which includes one or more continuous variables corresponding to prescriptions issued to at least one de- identified patient by at least one physician.
- the continuous variable is converted to a categorical variable having a number of levels. This conversion is performed for each one of a predetermined range of levels.
- the degree of statistical relationship is measured for the categorical variable with the dependent variable, i.e., the probability of the occurrence of an event relevant to the prescription prescribing practices of the physician in the therapeutic area of interest.
- This step of measuring is performed for each level of the predetermined range of levels of the categorical variable.
- a later stage in the process is to identify one of the number of levels of the predetermined range of levels that has the greatest statistically significant relationship with the occurrence of the event relevant to the prescription therapy practices of the physician.
- the steps of converting the continuous variable to a categorical variable, measuring the degree of relationship of the categorical variable with the dependent variable, and identifying one of the predetermined number of levels having the greatest statistically significant relationship with the dependent variable are repeated for each one of the continuous variables.
- the process may also include discarding a categorical variable that is not statistically significant at any number of levels.
- a later step is estimating the probability of the occurrence of the event relevant to the prescription therapy practices of the physician by running a predictive model using the categorical variables and the number of levels as determined above.
- the predetermined range of levels is between two levels and five levels.
- the process of converting each continuous variable to a categorical variable may include using a cumulative percentage distribution function.
- the step of measuring the degree of statistical relationship of the categorical variable with the probability of the occu ⁇ ence of the event may include running a logistic regression model, and calculating a p-value co ⁇ esponding to the categorical variable and the respective number of levels.
- the step of identifying the number of levels of the categorical variable having the greatest statistical significance comprises determining the respective number of levels of the categorical variable having the lowest associated p-value.
- FIG. 1 is a block diagram of an exemplary system in accordance with the invention.
- FIG. 2 is a flowchart illustrating a portion of an exemplary procedure in accordance with the invention.
- FIG. 3 is a flowchart illustrating a further portion of the procedure in accordance with the invention.
- system 10 may utilize several sources of information for processing.
- the user supplies information on a particular therapeutic area or market of interest 12, such as an anti-depressant therapy or blood pressure control therapy.
- the user may also supply information on certain prescription products which are to be included in the study 14.
- Time period information 16 i.e., an "observation period” may be selected by the user to specify the period of time in which to monitor the dispensing of prescriptions.
- Information on the specific prescriptions is included in prescription data, i.e., Retail Pharmacy Prescription data 18, which includes historical de- identified patient prescription data and is typically stored on a mass storage device, such as a disk drive or a tape.
- This input information in received by the system at the input device 20, such as, for example, a keyboard, mouse, disk drive, and the like.
- the system 10 uses longitudinal prescription data from retail pharmacies, Retail Pharmacy Prescription data stored on a mass storage device 18, which supplies information such as the prescribing physician, the name of the prescription product dispensed, the dosage, refill information, i.e., an indication of whether or not a refill is authorized, the day supply, i.e., the number of days until the patient will need a refill, and the date dispensed.
- Retail Pharmacy Prescription data 18 groups the above information for one patient under a "de-identified" patient identification number.
- the de-identified patient identification number is an identifier that replaces a patient's name and protects patient confidentiality since it provides no personal information about the patient. This information allows the system to track prescription therapy over time for one specific, although unknown, patient. Thus whenever a "patient” or “patient data” is described herein, it is understood that the patient's identity and personal information are excluded (i.e., the patient is "de- identified") in order to maintain confidentiality of patient records.
- the de-identified patient identification may also include the age and gender of the de-identified patient. While the disclosure herein is described with use of Retail Pharmacy Prescription data, other data structures could readily be employed, such as Pharmacy Benefit Manager (PBM) prescription claims data, mail order prescription data, or a combination of data sources.
- PBM Pharmacy Benefit Manager
- a prescription categorizer 24, data calculator 26, filter 28, and predictive model 30 perform a series of data processing operations by the central processing unit of a computer, executing software programs in languages such as COBOL, which are stored in dynamic computer memory, such as RAM (not shown).
- the computer is preferably a mainframe computer, such as an IBM 9672 mainframe computer.
- a software package, such as SASTM or SPSSTM may be installed on the computer to perform the statistical calculations. These software packages are used for processing the prescription data and developing the predictive model, as will be described below. Other equivalent software packages may also be used.
- the input data is received by the prescription categorizer 24 which first considers whether each de-identified patient is "track-able" to be included into the prescription categorization process. Once track-ability is confirmed, then the prescription categorizer 24 compares the dosage and prescription product for a particular prescription for a each de-identified patient with the dosage and prescription product of another prescription for that de-identified patient identification number and categorizes the particular prescription based on a change in the dosage or the prescribed medication between the particular prescription and the other prescription.
- Each prescription may be categorized by the system into the following exemplary categories: (1) New Therapy Start, (2) Therapy Switch, (3) Add-on Therapy (concomitant), (4) Titration Decrease, (5) Titration Increase, and (6) Continued Therapy.
- a number of continuous variables can be calculated by routines such as those performed by data calculator 26, which selectively obtains totals of the categories described above to obtain count data.
- the data calculator 26 may also calculate new variables that are functions of previously mentioned variables, such as ratios or observed data trends over time.
- the prescription data as calculated by the data calculator 26 is continuous.
- Continuous variables as used herein and generally understood in the art, are variables that are quantitative in nature, and can take on any value in a range. Thus, when continuous variables are plotted, the distances between points are meaningful.
- Examples of continuous variables that may be calculated by data calculator 26 are (a) the percentage share of categories, e.g., the percentage share of New Therapy starts for a physician, the percentage share of Continued Therapy for a prescription product; (b) count data, e.g., the total number of New Therapy starts for a product, the difference between the New Therapy start share and the Continued Therapy share; and (c) trend data, e.g., the change in New Therapy Start share over a period of time. Exemplary routines run by the data calculator 26 are discussed herein.
- the prescribing practices of a physician for a particular market of interest which includes "DRUG #1" can be observed by calculating several novel continuous variables.
- DRUG #1 total market share is calculated as the ratio of the total number of DRUG #1 prescriptions to the total number of prescriptions for all prescription products in the market of interest.
- additional market share information can be determined.
- the New Therapy Share of DRUG #1 can be calculated as the ratio of the number of New Therapy Starts for DRUG #1 to the total number of New Therapy Starts for all prescription products in the market of interest.
- the Therapy Switching Share to DRUG #1 is calculated as the ratio of the number of Therapy Switches to DRUG #1 to the total number of Therapy Switches for all prescription products in the market of interest.
- market share information may be calculated for Therapy Switching Share from DRUG #1, Titration Increases for DRUG #1, Titration Decreases for DRUG #1, New Concomitant Therapies, and the like.
- prescription data such as Retail Pharmacy Data
- the continuous variables are converted to categorical variables in the filter 28. It is noted that continuous variables are calculated in the exemplary embodiment by the prescription categorizer 24 and data calculator 26, described above. Alternatively, the continuous variables are supplied to the filter 28 from other sources input to the system 10 such as directly from the Retail Pharmacy Prescription data 18.
- the filter 28 includes routines which identify all the continuous variables to be converted, and subsequently converts each continuous variable to a categorical variable, using a function, such as a cumulative percentage distribution function. The steps performed by the filter 28 are described in greater detail below.
- a categorical variable has a number of levels. "Levels" are defined as the number of subdivisions within a categorical variable, as is known in the art. For example, the category New Therapy Start share may have two levels, e.g. "High” and "Low.” Depending upon the distribution of the data, the categorical variable may be better represented by three levels, e.g., "High,” “Low,” and also “Medium,” and so on for four or five levels.
- the filter 28 converts the continuous variable to a categorical variable having two such levels.
- the filter 28 also converts the continuous variable to a categorical variable having other levels.
- the filter 28 converts the continuous variable to a categorical variable having three levels, a categorical variable having four levels, and a categorical variable having five levels.
- the filter 28 supplies the categorical variables having each of the various levels to the predictive model 30 to determine the degree of statistical relationship of the categorical variable, e.g., New Therapy Start Share for DRUG #1, with the dependent variable, e.g., change in market share.
- the predictive model 30 uses a logistic regression model or a multinomial logistic regression model, as is known in the art, to determine a p-value.
- the filter 28 receives the p-values calculated by the predictive model 30 for each of the various levels and analyzes the results. The filter 28 discards categorical variables not showing a minimum statistical significance, as discussed below.
- the filter 28 identifies the optimal number of levels for a category that best represents the distribution of the data, based on the p-values computed above.
- the optimal number of levels is determined as the respective number of levels for a categorical variable exhibiting the lowest p-value.
- the predictive model 30 may be run again using the optimized categorical variables to estimate the probability of the occurrence of an event relevant to the prescription therapy practices of the physician, e.g., a change in the market share of a particular prescription product, and provide an physician profile data output 32, including series of alert messages, as will be described in greater detail below.
- step 100 all continuous variables available for analysis are identified and received (FIG. 2).
- the first continuous variable is selected for analysis at step 102.
- the conversion of the continuous variable to a categorical variable is performed to produce a categorical variable having a first number of levels, i.e., N m , makeup.
- N m first number of levels
- the number of levels N is initially set to N m j consumer at step 104.
- N OT 1, there are two levels for New Therapy Start share, i.e., "Low” and "High.”
- the conversion step occurs at step 106.
- a cumulative percentage distribution function is used to filter the data into a Low level of New Therapy Start share and a High level of New Therapy Start share.
- the first column lists the New Therapy Start shares for 20 different physicians.
- the New Therapy Start share for DRUG #1 is 2.48% of the New Therapy Starts for the market of interest.
- the New Therapy Start share for DRUG #1 is 5.70%, etc.
- the first level i.e., low market share for DRUG #1
- the second level i.e., mid market share for DRUG #1
- the third level i.e., high market share for DRUG #1
- All market share values are then converted as follows: any value that falls into the first level is converted to a 1 , as in the fifth column, above. Any value that falls into the second level is converted to a 2, and any value that falls into the third level is converted to a 3. For example, the value of 28.93% would be converted to a 3 because it falls into the "high" range.
- the predictive value of the categorical variable having N levels is tested at step 108. Particularly, this step is measuring the degree of statistical relationship for the categorical variable (having N levels) with the dependent variable.
- the predictive model 30 uses a logistic regression model or a multinomial logistic regression model, as is known in the art, to calculate the degree of statistical relationship of the categorical variable and its respective number of levels, with the dependent variable.
- the dependent variable in the model is the probability of an occurrence of an event relevant to the prescription therapy practices of the physician in the market of interest. Examples of such events are (1) a change, e.g., an overall loss, of percentage market share for a product, or (2) a low uptake of a new product.
- the dependent variable may also be categorical with most likely three or fewer levels.
- logistic regression is used to estimate the probability of an event occurring.
- the output of step 108 is a p-value.
- the probability of an event occurring can be expressed as:
- An event may be, for example, a change in market share for DRUG #1
- equation [2] (the dependent variable).
- equation [2] is an independent, categorical variable
- B is a model coefficient.
- equation [2] may include one independent variable X to compute the optimum number of levels of the categorical variable. Subsequent steps may incorporate several independent variables X, as will be described below.)
- the coefficients are provided by running the standard logistic regression model on statistical software such as SASTM or SPSSTM, described above, according to a method known in the art.
- the conversion process is repeated if the number of levels is less than five. No more than five levels will be tested for each variable. Having more levels could compromise the predictive accuracy, because more degrees of freedom would be used in the predictive model.
- Degrees of freedom are the number of observations (or scores) that are free to vary. Each time a restriction limits the freedom of scores to vary, a degree of freedom is used. A level of a categorical variable would constitute such a restriction. For instance, if a variable has three levels, three degrees of freedom will be used. As the number of levels grows within and across variables, more degrees of freedom will be used.
- step 106 If the number of levels for the categorical variable is less than five for that iteration, then the number of levels Nis increased by one at step 112, and the conversion process of step 106 is repeated to create a categorical variable having N+1 levels. Steps 106 and 108 are repeated until categorical variables having 2, 3, 4 and 5 levels are calculated for the first continuous variable. If the number of levels exceeds five at step 110, the iterative process ends, and the data flow continues to step 120 (See FIG. 3). It is noted that the steps of converting continuous variables to categorical variables (step 106) and of measuring the degree of statistical relationship of the categorical variable with the dependent variable (step 108) may proceed in separate iterative loops.
- the categorical variables for each one of the levels may be calculated first, and then the step of measuring the predictive value of the categorical variables may be subsequently performed for each one of the levels.
- categorical variables for each one of the levels may be converted simultaneously.
- the p-values of each of the levels of the categorical variable are analyzed to determine whether they are statistically significant, i.e. whether they have at least a minimum statistical significance with respect to the dependent variable. If the p-value for the variable at any number of levels is less than or equal to 0.05 as determined at step 120, the variable is considered to be statistically significant and thus having predictive value, and the process proceeds to step 122.
- p-value for the variable is not less than or equal to 0.05, that variable is discarded at step 124.
- a p-value of 0.05 has been used in the exemplary embodiment, although it is noted that a different p-value may be used as a threshold value for statistical significance.
- step 126 determines whether all variables have been tested. If other variables are to be tested, the process proceeds to step 114 (FIG. 2), in which the next continuous variable is selected, and the categorical determination process, i.e., steps 104-124, is repeated for the each subsequent variable.
- step 130 is a further optimization of the categorical determination process, in which all levels of all variables are now evaluated in conjunction with each other to maximize predictive accuracy.
- steps 102-126 are repeated substantially identically as described above, with the following changes noted herein.
- equation [2] above may incorporate several independent variables X, rather than one independent variable, as described above. Particularly, all permutations and combinations of levels across all variables will be tested in a sequential iterative fashion to reach maximum accuracy defined by the lowest p-value.
- the predictive model 30 is run at steps 132-134 to estimate the probability of the occurrence of dependent variable, i.e., an event relevant to the prescription therapy practices of a physician.
- the predictive model which is a logistic regression model, is run using the levels of categorical variable obtained in steps 102-124 and refined in step 130.
- This process of step 132 produces a series of model coefficients such as coefficients Bo, B ⁇ , -9 2 ... B v represented in equation [2] above.
- the model coefficients, as produced above, are subsequently applied to each data for each physician at step 134 to estimate a probability of occurrence of an event related to the physician's prescription therapy practices as described in equation [1] above. For example, at step 134 a particular physician may be found to have a 65% chance of trending down on a particular therapy next month, based on the data available for New Therapy Start shares and trends, Continued Therapy shares and trends, and Titration Down shares and trends, for example.
- a series of alert messages are produced based upon the probabilities generated at step 134, by reference to a table in which percentage values of the probabilities are associated with alert messages.
- the physician may be found to have a 65% chance of trending down on a particular therapy.
- 50% is considered equivalent to an event occurring by chance, above 50%, the event is more likely to occur (i.e., it is above chance) and below 50% it is less likely to occur.
- 65% is 15% above the event occurring by chance, thus the value would be flagged in the database (as all values greater than 50%).
- An alert message communicating that a particular physician will down trend next month on a therapy is generated. Such an alert message would be conveyed to a sales representative having sales responsibility in the prescription field.
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Application Number | Priority Date | Filing Date | Title |
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JP2003544646A JP2005509955A (en) | 2001-11-14 | 2001-11-14 | System and method for generating a physician profile related to prescription practice using a self-fit prediction model |
CA002466679A CA2466679A1 (en) | 2001-11-14 | 2001-11-14 | System and methods for generating physician profiles concerning prescription therapy practices with self-adaptive predictive model |
US10/494,841 US20040249669A1 (en) | 2001-11-14 | 2001-11-14 | System and methods for generating physician profiles concerning prescription therapy practices with self-adaptive predictive model |
AU2002230467A AU2002230467B2 (en) | 2001-11-14 | 2001-11-14 | System and methods for generating physician profiles concerning prescription therapy practices with self-adaptive predictive model |
EP01990702A EP1444618A1 (en) | 2001-11-14 | 2001-11-14 | System and methods for generating physician profiles concerning prescription therapy practices with self-adaptive predictive model |
PCT/US2001/043900 WO2003042886A2 (en) | 2001-11-14 | 2001-11-14 | System and methods for generating physician profiles concerning prescription therapy practices with self-adaptive predictive model |
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PCT/US2001/043900 WO2003042886A2 (en) | 2001-11-14 | 2001-11-14 | System and methods for generating physician profiles concerning prescription therapy practices with self-adaptive predictive model |
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JP (1) | JP2005509955A (en) |
AU (1) | AU2002230467B2 (en) |
CA (1) | CA2466679A1 (en) |
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Cited By (1)
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US11568452B2 (en) * | 2012-10-31 | 2023-01-31 | Continuum Health Technolgies Corp. | Statistical financial system and method to value patient visits to healthcare provider organizations for follow up prioritization |
-
2001
- 2001-11-14 EP EP01990702A patent/EP1444618A1/en not_active Ceased
- 2001-11-14 CA CA002466679A patent/CA2466679A1/en not_active Abandoned
- 2001-11-14 AU AU2002230467A patent/AU2002230467B2/en not_active Expired
- 2001-11-14 WO PCT/US2001/043900 patent/WO2003042886A2/en active Application Filing
- 2001-11-14 JP JP2003544646A patent/JP2005509955A/en active Pending
Cited By (1)
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US11568452B2 (en) * | 2012-10-31 | 2023-01-31 | Continuum Health Technolgies Corp. | Statistical financial system and method to value patient visits to healthcare provider organizations for follow up prioritization |
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CA2466679A1 (en) | 2003-05-22 |
EP1444618A1 (en) | 2004-08-11 |
JP2005509955A (en) | 2005-04-14 |
AU2002230467B2 (en) | 2008-11-20 |
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