During the period studied, 2.9 million prescriptions were dispensed; 83,784 (2.9%) were for NSAIDs: 24,377 were for COX-2-selective NSAIDs (29°%), and 59,407 were for nonselective NSAIDs (71°%). From April to September 2004, an average of 2,299 prescriptions for COX-2-selective NSAIDs were dispensed each month.

Following the withdrawal of rofecoxib (in late September 2004) and valdecoxib (in April 2005), this number dropped steadily during the successive three-month periods—from October to December 2004, from January 2005 to March 2005, and from April 2005 to June 2005—to monthly averages of 1,632, 1,122, and 775 prescriptions, respectively. By the beginning of 2005, the total number of NSAID prescriptions dispensed had decreased by 22% (Figure 1). discount drugs canda

Figure 1 Total number of prescriptions

Figure 1 Total number of prescriptions for COX-2-selective and nonselective nonsteroidal anti-inflammatory drugs (NSAIDs) dispensed between April 1,2004, and June 30,2005.

During the same three-month time periods, the number of nonselective NSAID prescriptions remained relatively constant, at slightly more than 3,000 per month, until the third three-month time period (April 2005 to June 2005), when an increase of almost 33% occurred (to more than 4,000 per month).

Before October 2004, the COX-2-selective agents had accounted for 37% of all of the NSAID prescriptions dispensed. Beginning in October 2004, the total number of NSAID pre­scriptions decreased, primarily because of a reduction in the number of prescriptions for COX-2-selective NSAIDs. The COX-2 agents, therefore, were a progressively smaller proportion of total NSAID prescriptions dispensed throughout the time studied, and this number decreased to 16% of the total number of NSAID prescriptions for the final three-month time period studied (from April 2005 to June 2005).

Figure 2 Number and type of prescriptions for nonsteroidal

Figure 2 Number and type of prescriptions for nonsteroidal anti-inflammatory agents (NSAIDs) dispensed from April 2004 through June 2005. APC = Adenoma Prevention with Celecoxib trial; ADAPT = Alzheimer’s Disease Anti-inflammatory Prevention Trial.

During the 15 months studied, the number of ibuprofen prescriptions remained relatively stable, and there was a modest increase (from 12% to 25%) for most other nonselective NSAIDs after rofecoxib was removed from the market (Figure 2). However, the percentage of prescriptions (Canadian Mobic, Boehringer Ingelheim) increased by 160%, from an average of 127 prescriptions per month (from April 2004 to September 2004) to a high of 330 in June 2005.

The number of prescriptions for naproxen sodium (Naprosyn, Roche) temporarily increased; however, after the Food and Drug Administration (FDA) issued advisories and news releases in late 2004, this number decreased by 38% and 20%, respectively (Figure 2).