HSRN DATA BRIEF: NATIONAL PRESCRIPTION AUDIT™
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`DATA SUMMARY
`The National Prescription Audit™ (NPA) is an industry standard source of national
`prescription activity for all pharmaceutical products. NPA measures demand for
`prescription drugs, including both what the provider prescribes in the retail setting and
`what is ultimately dispensed to consumers across four unique channels. From the
`selected pharmacies, IMS collects new and refilled prescription for every day of the
`month. Data are available on a monthly and weekly basis at varying levels of depth. For
`example, data can be analyzed and stratified by patient age, patient gender, co-payment,
`and four methods of payment. NPA is useful to address a variety of research topics
`examining pharmaceuticals, especially investigations that focus on prescription drug
`utilization, Rx size, average consumption, and more than 90 prescriber specialty
`groupings representing over 170 specialties. The NPA represents and captures over 70%
`of all prescription activity in the United States, including Alaska and Hawaii, and covers
`all products, classes, and manufacturers. Although the NPA provides data at a national
`level, data that is summarized into the NPA is also available at more granular geographic
`levels. This product, the IMS Health Xponent™ database, is described separately.
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`DATA SAMPLE
`From the universe of retail, standard mail service, specialty mail service and long-term
`care pharmacies, IMS selects a representative sample stratified by geographic location.
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`Universe
`The pharmacy universe is comprised of more than three billion prescriptions from retail,
`mail service, and long-term care pharmacies. NPA estimates in 2011 are based on a
`universe of approximately 57,000
`retail pharmacies
`(including
`chain/mass
`merchandisers, independent, and food-store pharmacies), 327 non-governmental mail
`service pharmacy outlets, and ~3,000 long-term care facilities, including nursing homes
`and nursing home providers. Data collected from HMOs that serve HMO members only,
`dispensing physicians, hospital pharmacies, home healthcare, and clinic pharmacies are
`not included.
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`Sample
`As of 2011, NPA includes 38,000 retail stores and collects randomly drawn and electronically
`submitted retail pharmacy data for new and refilled prescription for every day of the month.
`All mail service pharmacy outlets are invited to participate and most participating outlets
`are used in the sample. As of 2011, NPA™ includes approximately 119 mail service
`pharmacy outlets. Finally, the NPA™ sample also includes ~820 long-term care facilities.
`Alternative data sources are used to enhance the accuracy of the audited data and to allow
`for robust national projections.
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`IMS Health
`200 Campus Drive
`Collegeville, PA 19426
`USA
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`Tel 610-244-2000
`Fax 610-244-5007
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`SENJU EXHIBIT 2192
`INNOPHARMA v SENJU
`IPR2015-00903
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`ALTERNATIVE DATA SOURCES AND RELATIVE STRENGTHS OF THE NPA
`There are many alternative sources of data regarding prescription drug utilization,
`ranging from retail pharmacy claims, to combined pharmacy and medical claims, to data
`from electronic health records. The main benefit of the NPA is its coverage and scope,
`which are particularly important in analyses that attempt to provide a snapshot of
`national prescription drug utilization or expenditures. In addition, the NPA includes
`detailed information regarding unique channels of distribution such as standard and
`specialty mail service and long-term care, which may be particularly valuable for
`investigations examining the use of medications to treat chronic conditions or specialty
`therapies.
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`KEY DATA ELEMENTS
`NPA provides data elements related to volume of dispensed prescriptions for new, refill and
`total prescriptions.
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`Data Category
`Prescription characteristics
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`Product details
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`Patient and physician
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`Cost
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`Data Details
`• Dispensed volume, including new, refill, total
`• Week of prescription dispensed
`• Number of pills dispensed
`• Anatomical and Uniform System of Classification (USC) codes
`• National Drug Code
`• Length of therapy
`• Daily dose
`• Patient age and gender
`• Physician specialty
`• Cost to patient
`• Cost to pharmacy
`• Level of copayment based on predefined strata
`• Payment type, including cash, Medicaid, Commercial Third
`Party, and Medicare Part-D
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`PUBLICATIONS USING DATA SOURCE
`The National Prescription Audit™ is particularly valuable for addressing research questions
`that focus on trends or estimates of prescription use or costs that do not require detailed
`clinical information such as data that is present in health plan claims. Below are examples
`of recently published works using the NPA.
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`1. Dorsey ER, Thompson JP, Dayoub EJ, George B, Saubermann LA, Holloway RG.
`Selegiline Shortage: Causes and Costs of a Generic Drug Shortage. Neurology.
`2009;73:213-7. Abstract
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`The authors used the National Prescription Audit™ to gather monthly total prescriptions
`filled for generic selegiline in the United States from February 2002 through December
`2006. In addition, the authors were able to use the NPA™ to capture demand levels
`experienced by individual firms producing selegiline, as well as to analyze the effect of
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`the shortage on the sales of branded capsules, orally disintegrating tablets, and sales of
`the monoamine oxidase inhibitor rasagiline.
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`2. Martin-Doyle W, Essebag V, Zimetbaum P, Reynolds MR. Trends in US Hospitalization
`Rates and Rhythm Control Therapies Following Publication of the AFFIRM and RACE
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`Trials. J Cardiovasc Electrophysiol. 2010 Nov 18. [Epub ahead of print]  Abstract 
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`The authors used the National Prescription Audit™ to examine the impact of trials
`comparing rate vs. rhythm control for atrial fibrillation on the use of rhythm control
`therapies and hospitalizations in the United States. Use of rhythm control therapies
`declined significantly after publication of the AFFIRM and RACE trials until 2005, when
`trends reversed and an increase in the use of catheter ablation for atrial fibrillation was
`also observed.
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`3. Aitken M, Berndt ER, Cutler D. Prescription Drug Spending Trends In The United States:
`Looking Beyond The Turning Point. Health Affairs. 2009;28:w151-w160. Abstract
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`The authors used the National Prescription Audit™, coupled with the IMS Health National
`Sales Perspective™, to document trends and identify underlying components in
`prescription drug expenditures. They identify an important decline in the role of
`blockbuster drugs, as well as the increased importance of biologics and vaccines relative
`to traditional pharmaceuticals and a changing medication mix away from those
`prescribed principally by primary care physicians toward those mostly prescribed by
`specialists. Implications for providers, patients, and industry are discussed
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