Improving Hydroxyurea Uptake in Children: Results from a Provider Incentive Program in a Large Metropolitan Health System

Hydroxyurea is an oral medication that increases fetal hemoglobin production and has been deemed a safe and effective treatment for sickle cell disease (SCD) in children; however, utilization and adherence remain suboptimal, especially among children. We evaluated the impact of a provider incentive program aimed at increasing the use of hydroxyurea among children in a large metropolitan health system using a pre-post comparison. The primary outcome was an active hydroxyurea prescription. Secondary outcomes of hydroxyurea use, hydroxyurea adherence, acute care utilization, and cost of acute care were calculated for a subset of the population enrolled in Medicaid. Significant increases over time and among providers participating in the incentive program were found in active hydroxyurea prescriptions and among Medicaid children hydroxyurea fills. These findings may inform future provider interventions aimed at increasing provider knowledge of SCD treatments and improving pediatric hydroxyurea counseling and prescribing practices.