How did media attention impact minoxidil hair loss treatment prescribing patterns?

In a recent study published in JAMA Network Open, researchers investigated changes in oral minoxidil prescribing following an article describing the successful treatment of alopecia (loss of hair) with oral minoxidil instead of topical minoxidil.

Study: Changes in Minoxidil Prescribing After Media Attention About Oral Use for Hair Loss. Image Credit: Andrei_R/Shutterstock.com

Background

Changes in clinical practice and patient habits may be linked to media coverage of health-associated news. Despite growing interest in health-associated news during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak, data on the association between social media and such behaviors remains sparse.

On 18 August 2022, The New York Times published an article outlining the beneficial treatment experiences of various dermatologists and the findings of a small-scale observational analysis of females with alopecia who received low-dose oral minoxidil instead of topical application of the drug.

Further research on the oral use of minoxidil could influence minoxidil prescribing.

About the study

In the present cross-sectional study, researchers investigated changes in prescribing oral minoxidil after extensive media coverage of an article reporting the benefits of oral minoxidil in managing alopecia by news agencies and social media, using deidentified drug prescription data.

The study included adult individuals who were orally administered minoxidil between 1 January 2021 and 31 December 2022, per the electronic medical records in the United States (US) Truveta data system.

The participants received treatment from eight healthcare systems, resided primarily in 13 US states, and were administered oral minoxidil for the first time before (between January and July of 2022) the news article publication or post (between August and December 2022) the publication.

The first-time orally administered minoxidil prescription rate for 2.50 milligrams and 5.0 milligrams tablets per week was calculated. The team excluded minoxidil 10.0 mg tablets that are used to manage hypertension.

Weekly drug prescription rates were analyzed by interrupted-type time-series analysis, considering autocorrelations using autoregressive and integrated moving averages modeling.

Oral minoxidil effects were compared to low-dosage finasteride medication prescription for hair loss [excluding a 5.0 mg dose of finasteride, which is used to manage benign prostatic hyperplasia (BPH)] and antihypertensive drug (since minoxidil belongs to the same class of medications) prescription for the first time.

Results

Out of 6,541 individuals prescribed oral minoxidil for the first time, 41% were male; 37% were aged 45 to 64.0 years; 8.0% were Asians; 13% were Blacks; 65% were Whites; and 10% were Hispanics. Among the participants, 2,846 and 3,685 individuals were prescribed oral minoxidil before and after the article's publication, respectively.

The percentages of men (44% versus 38%) and Whites (69% versus 61%) were greater after versus before the article's publication.

On the contrary, the percentage of participants with comorbid conditions reduced after versus before the article's publication (diabetes mellitus: 16% versus 22%; hypertension: 38% versus 47%; chronic renal disorder: 14% versus 22%).

Weekly rates of oral minoxidil prescriptions for the first time among every 10,000 outpatient visits were significantly greater eight weeks after versus eight weeks before publication of the article (0.90 versus 0.50) and for men (1.10 versus 0.50, indicating an increase of 2.40-fold) and women (0.80 versus 0.50, indicating an increase of 1.70-fold).

Following an early rise in oral prescriptions related to the article's publication, oral minoxidil prescribing was reduced for men and women. Similar elevations were not observed in antihypertensive or finasteride prescribing for the first time.

Conclusions

The study findings showed an immediate increase in oral minoxidil prescribing following a newspaper article reporting the oral administration of low-dosage minoxidil for alopecia treatment.

Notably, the news article didn't report any new scientific observations or findings from large randomized controlled trials. The study findings indicated that increased media coverage, even without presenting novel research or backed by weak scientific evidence, might instantaneously alter drug prescribing; however, the changes might not persist for long periods.

The underlying variables involved with changes in drug prescription behavior of doctors and/or patients, as well as gender disparities, must be understood.

Individuals orally consuming low doses of minoxidil following the article's publication may be influenced by socioeconomic characteristics, including access to healthcare services, educational level, and annual household income.

The study's limitations include the inability to generalize the findings to populations that were not included, the likelihood of an undetected concurrent event related to higher-dose oral minoxidil prescriptions, and the possibility of misclassifying individuals consuming 10.0 mg of minoxidil in divided doses to treat alopecia.

Written by

Pooja Toshniwal Paharia

Dr. based clinical-radiological diagnosis and management of oral lesions and conditions and associated maxillofacial disorders.