Off-label utilization of antihypertensive medications in children.

OBJECTIVE To examine off-label use and costs of antihypertensive drugs in children by using a national sample of prescription claims. METHODS We conducted a cross-sectional study using the 2002 Medstat MarketScan Database, a national sample of outpatient prescription claims of children or=12 years were more likely to be prescribed off-label antihypertensives (53%) compared with children aged <or=5 (46%) and 6-11 years (42%; P < .001). Off-label use varied significantly by class of antihypertensive drugs (P < .001). Overall, off-label antihypertensives were significantly more expensive than on-label antihypertensives. CONCLUSIONS Despite availability of often less expensive on-label alternatives for the same class of antihypertensive drugs, off-label antihypertensive drugs were prescribed frequently in children. These findings underscore the potential clinical and economic implications of common off-label prescribing, for children, their parents, physicians, and payers.