Patient story: Should you take 1 pharmacy claim = 1 TRx = 1 Quantity of drug?

Patient story: Should you take 1 pharmacy claim = 1 TRx = 1 Quantity of drug?

Back in 2016, projects involving patient claims data were so confidential that we weren’t even allowed near the teams working on them 😜. The dataset’s name—APLD (Anonymous Patient-Level Data)—felt fittingly mysterious.

Fast forward to around 2020, I finally got to work with this data, diving into patient journey mapping and launch analytics, since IO therapies became mainstream. By then, APLD had become more commonly known as claims data.

Today, patient claims data is at the forefront of analytics—used daily for patient cohort analysis, HCP targeting, drug launch planning, and market TRx tracking. And one of the first questions that comes up in any analysis is:

Should you treat 1 pharmacy claim = 1 TRx = 1 Quantity of the drug?

TRx (Total Prescriptions) refers to the total number of times a medication is prescribed, including both new prescriptions and refills. But does 1 claim = 1 TRx = 1 quantity or unit (like a bottle or vial)?

For specialty drugs, this is often true. Many U.S. payers impose quantity limits on these high-cost medications, typically allowing only one unit per claim due to pricing concerns. 

However, the more reliable approach is to use both QUANTITY and DAYS SUPPLY fields (Since fewer than 5% of rows in the claims data have a quantity of 1, the vast majority contain quantities of 2 or more). This way, you can accurately estimate total quantity dispensed or revenue based on those additional fields.

"Follow" me for more such stories

Read past stories like above at https://lnkd.in/d9ijze8r