Using routinely-collected data to evaluate healthcare policy: a case study exploring the impact of the Women’s Health Initiative study on hormone therapy use in Australia

Abstraksi

Background: Evidence from well-conducted research is essential to support effective healthcare policy development. One evidence source is routinely collected data (RCD): commonly collected for clinical and administrative purposes without a priori research questions (e.g. pharmaceutical dispensing systems and disease registries). RCD provides complementary, often population-based, information not usually captured in other types of studies. Our objective was to examine the impact of the Women’s Health Initiative studies (2002 and 2007) on hormone therapy (HT) use in Australia. Methodology: We conducted an interrupted time series analysis (ITSA) using RCD in Australia. We used two datasets: 1) medicines dispensed data from the Pharmaceutical Benefits Scheme, a national subsidised formulary; and 2) sales data from a pharmaceutical market research company (IQVIA). Results: After 2002, HT use significantly decreased for most medicine classes, strengths, and routes, except vaginal HT. The use of most HT products continued to decrease more slowly after 2007 despite evidence and guideline changes. Implication: By analyzing RCD, we can quantify the impact of events on HT use and provide recommendation for further policy development. In the Indonesian context, using RCD with ITSA provides an efficient and cheap approach to studying the impacts of healthcare interventions. Badan Penyelenggara Jaminan Sosial Kesehatan (BPJS) is the administrator of the Indonesian national health insurance scheme and has collected electronic data since 2014. We can use these RCD to examine differences in healthcare use and needs across regions in Indonesia. Such evidence can then contribute to more efficient and effective healthcare policy and treatment approaches.