Medication Utilization in Children Born Preterm in the First Two Years of Life

OBJECTIVE: To compare medications dispensed during the first two 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 two years, of which 25 408 (7.7%) were preterm (<37 weeks). Filled prescription claims and paid amount over two 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 two is driven by palivizumab, anti-reflux, and respiratory medications, despite little evidence regarding efficacy for many medications, and concern for harm with certain classes.