Impact of parameter settings on the estimation of drug exposure with the individualized dispensing patterns method
4 affiliations
- 1Institut Pierre Louis d'épidémiologie et de Santé publique (IPLESP) Sorbonne Université, INSERM Paris France
- 2Département de Médecine Générale Université Paris Cité Paris France
- 3Service de Pharmacologie médicale et clinique, CIC 1436 INSERM, Université de Toulouse, Centre Hospitalo‐Universitaire de Toulouse (CHU Toulouse) Toulouse France
- 4Hôpital Tenon, Service de Médecine Interne Assistance Publique–Hôpitaux de Paris (APHP) Paris France
Abstract
Aim: To assess the impact of parameter settings when using the individualized dispensing patterns (IDP) method to estimate exposure duration from dispensing data.
Methods: We conducted a cohort study using a 2% representative sample of the French healthcare insurance database from 2013 to 2022. The IDP method derives drug exposure distribution in a population sample, applies a selected percentile of this distribution to each individual's initial dispensing and then adjusts subsequent exposures at the individual level, incorporating a possible grace period to link consecutive dispensings into continuous exposure episodes. We studied two drugs with contrasting prescribing patterns: tramadol and rivaroxaban. We varied four parameters independently, compared median episode duration estimates and assessed consistency of exposed days estimates using kappa coefficients.
Results: With the original IDP parameters, median continuous exposure episodes were 47 days for tramadol and 79 days for rivaroxaban. The impact of parameter choice was drug‐specific: Percentile selection affected both drugs (kappa 0.58–0.65 for tramadol; 0.89–0.93 for rivaroxaban), sample population definition affected tramadol only (kappa 0.76), and grace period affected rivaroxaban (kappa 0.74–0.87). Heterogeneity across individual‐level kappa values was always high (I 2 > 80%). These results informed the selection of drug‐specific parameters, yielding clinically more plausible median episode durations: 15 days for tramadol and 96 days for rivaroxaban.
Conclusion: Consumption patterns in the study population should guide percentile and grace period selection. Tailored accordingly, the IDP method provides an adaptable framework for estimating drug exposure from databases. Transparent reporting of parameter selection is essential to ensure reproducibility and interpretability.
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BibTeX
@article{gosselin2026impact,
title = {{Impact of parameter settings on the estimation of drug exposure with the individualized dispensing patterns method}},
author = {Laëtitia Gosselin and Clara Lévy and Noémie Sève and Thierry Blanchon and Marianne Sarazin and Louise Rossignol and Maryse Lapeyre‐Mestre and Nathanaël Lapidus and Olivier Steichen},
journal = {British Journal of Clinical Pharmacology},
year = {2026},
month = jul,
doi = {10.1002/bcp.70701},
url = {https://doi.org/10.1002/bcp.70701},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Impact of parameter settings on the estimation of drug exposure with the individualized dispensing patterns method
AU - Laëtitia Gosselin
AU - Clara Lévy
AU - Noémie Sève
AU - Thierry Blanchon
AU - Marianne Sarazin
AU - Louise Rossignol
AU - Maryse Lapeyre‐Mestre
AU - Nathanaël Lapidus
AU - Olivier Steichen
PY - 2026
DA - 2026/07/21
JO - British Journal of Clinical Pharmacology
DO - 10.1002/bcp.70701
UR - https://doi.org/10.1002/bcp.70701
AB - Aim: To assess the impact of parameter settings when using the individualized dispensing patterns (IDP) method to estimate exposure duration from dispensing data. Methods: We conducted a cohort study using a 2% representative sample of the French healthcare insurance database from 2013 to 2022. The IDP method derives drug exposure distribution in a population sample, applies a selected percentile of this distribution to each individual's initial dispensing and then adjusts subsequent exposures at the individual level, incorporating a possible grace period to link consecutive dispensings into continuous exposure episodes. We studied two drugs with contrasting prescribing patterns: tramadol and rivaroxaban. We varied four parameters independently, compared median episode duration estimates and assessed consistency of exposed days estimates using kappa coefficients. Results: With the original IDP parameters, median continuous exposure episodes were 47 days for tramadol and 79 days for rivaroxaban. The impact of parameter choice was drug‐specific: Percentile selection affected both drugs (kappa 0.58–0.65 for tramadol; 0.89–0.93 for rivaroxaban), sample population definition affected tramadol only (kappa 0.76), and grace period affected rivaroxaban (kappa 0.74–0.87). Heterogeneity across individual‐level kappa values was always high (I 2 > 80%). These results informed the selection of drug‐specific parameters, yielding clinically more plausible median episode durations: 15 days for tramadol and 96 days for rivaroxaban. Conclusion: Consumption patterns in the study population should guide percentile and grace period selection. Tailored accordingly, the IDP method provides an adaptable framework for estimating drug exposure from databases. Transparent reporting of parameter selection is essential to ensure reproducibility and interpretability.
SN - 0306-5251
SN - 1365-2125
ER -