ProHeart 6 (moxidectin): The Value of the Second Dose

ProHeart? 6 (moxidectin): The Value of the Second Dose*

Introduction

ProHeart 6, an injectable prescription parasiticide, is the only U.S. Food and Drug Administration (FDA)-approved injectable heartworm disease preventative that protects dogs for six months against heartworm disease caused by Dirofilaria immitis; it also treats preexisting infections with common hookworms (Ancylostoma caninum and Uncinaria stenocephala).

ProHeart 6 is the only heartworm disease preventative that ensures six months of continuous protection in a single dose and can only be administered by veterinarians and staff.

A 2015 study analyzed a total of 1,626 veterinary invoices for 918 dogs receiving an appropriately timed second dose of ProHeart 6 (within 5?7 months of an initial dose). The study found that beyond ensuring year-round compliance with a heartworm disease prevention regimen, the second dose offers additional benefits for the patient, the pet owner and the practice (Figure 1).

Figure 1 -- Benefits of the ProHeart 6 Second Dose

For the Patient Year-round protection Early detection of disease

For the Pet Owner Convenient peace of mind

For the Veterinary Practice Veterinarian-controlled compliance Healthier practice

About the study

This study enrolled 18 veterinary practices from eight states. All practices supplied invoices for 2009?2014. The 1,626 invoices analyzed in the study all met the criteria for a ProHeart 6 second dose (i.e., one given 5?7 months after the initial dose). The invoices also included anonymous data about health observations, patient health status, medical issues addressed, products or services the client purchased during the visit and any charges associated with the visit. All patients met the label requirements for ProHeart 6 administration; no exclusion criteria were applied for patient age, breed, size or gender.

TABTLAEB1L:EM1:EMDTIECADABILCLAEISL1S:IUSMESESUDEIIDSCEAINDLTEIINSFSITEUIDFEIESADTIDAPETRNOPTHRIFEOIAHERDETAAR6TTP6ROHEART 6

Key findings

SECSOENCODNVDISVITISS*EITC*OND VISIT* DiaDginaogsnisosTiyspTeDyipaegnosis Type

TABLE 1: MEDICAL ISSUES IDENTIFIED AT PROHEART 6 PerPcerncteangtea(gNePSo(eE.N)rCcoSTOe.AE)STNnBCAEtDOLaBCEgNVOLe1EIDNS:(1DNIVMT:IoVM*SE.I)DSETIDI*CTIA*CLAILSISSUSEUSESIDIEDNETNITFIEFIDEDATAPTRPORHOEHAERATR6T 6

Medical issues addressed DermDaetromloagtoiclogic Dermatologic

28.32%8.3%(100(/13D05i03a2/)38gD5.n33iD%a)oigsanigson(Ts1o0yis0p/ie3Ts5y3Tp)yepe

Percentage (No.) PePrecrecnetnatgaeg(eN(oN.)o.)

As a direct consequence of being broDuengDtahel nttalin forDpenhtayl sical exams at the time of the ProHeart 6 seconOdticOdtioc se, 21O.7tic% of patients

ElecEtilveectsivuergseurrygeErlyective surgery

18.71%8.7% (66/3D(65e63r1/)m385.a73to%)logic (66/353) DeDrmeramtoaltoogloicgic

12.21%2.2% (43/3D(45e33n1/)3t2a5.l23%) (43/353) 10.81%0.8% (38/(3O358t3i1/c)30D5.8e3D%n)teanltal (38/353)

28.3% (100/353) 282.38%.3% (10(100/305/35) 3)

18.7% (66/353) 181.78%.7% (66(6/365/35) 3)

12.2% (43/353)

(353/1,626) had at least one medicOartlhOoisprtehsdouipceedicadOdrrtheospesdeicd at the

8.8%8.8% (31/3E(35l1e3/c)38Ot5i.8vt3Oi%ec)tiscurge(r3y1/353)

121.22%.2% (43(4/335/35) 3) 10.8% (38/353)

time of the second dose. Of those 35U3rogUpernoaigttaelineitanl ts,U3ro1g5enit(a8l 9%) had

3.4%3.4% (12/3O(15r23th/)33oE5.p4l3eeE%)dclitecicvteivs(eu1rs2gu/3er5gry3e)ry

101.80%.8% (38(3/385/335)3) 8.8% (31/353)

a new medical condition diagnosed. GTahstGreoaisnnttreoesitnwitneasltyinaGildasetrnoitntiefsiteindal issues

3.1%3.1% (11/3U(15r13o/)g33Oe5.n1r3Oti%)htarotlhpoedpie(cd1i1c/353)

8.88%.8% (31(3/315/35) 3) 3.4% (12/353)

spanned a wide range of acute, chroOnphiOtchpahlamthniacldmicothOpehrthaclmoinc ditions. Table 1 shows the breakdown of medMicetaaMbleotliaiscbosluices Mideteabnolticified at the time of the ProHeart 6 second-doseCvairsdCiioatlro.dgioiclogic Cardiologic

All oAthlleor ther All other

UrUogroengietnailtal 3.1%3.1% (11/3G(15a13s/)t33r5o.13in%)testina(l11/353) 2.5%2.5% (9/3O5(p93h/)3t2Gh5.a5a3Gl%s)mtarisoctirnotienst(tei9ns/ta3iln5a3l) 2.3%2.3% (8/3M5(8e3t/)a32Ob5.3op3O%lh)iptchhatlhmalimc(8ic/353) 6.8%6.8% (24/3C(25a43r/d)36Mi5o.83leMo%)tagebitcoablioc(li2c4/353)

3.43%.4% (12(1/325/35) 3) 3.1% (11/353)

3.13%.1% (11(1/315/35) 3) 3.1% (11/353)

3.13%.1% (11(1/315/35) 3) 2.5% (9/353)

2.52%.5% (9/(395/35) 3) 2.3% (8/353)

MedMiceadl icssaul eissauses%Masoefd%itcooatafllitsocstauasleescsaasse%s of total cases21.72%1.7%(353(/315,A632/l1l62,o)61Ct2.h7a6eCr%)rdairodl(io3og5loi3cg/1ic,626)

2.32%.3% (8/(385/35) 3) 6.8% (24/353)

AlAl ollthoetrher NewNmewedmicaelddicialgdnioNasgeewnsoamssee%sdaisocaf%ltodotiafalgtocnatoassleecssaasess% of tot1a9l.c4a1%s9e.s4%(315(/311,M652/e161d,)69ic2.4a6l%)issu(3es15a/s1%,62o6f)total cases

6.86%.8% (24(2/345/35) 3) 21.7% (353/1,626)

MeMdiecdailciaslsiusessueas a%s %of otofttaoltcaal sceasses

212.71%.7%(35(35/13,/612,62) 6)

New medical diagnoses as % of total cases

19.4% (315/1,626)

*Prio*rPPriroorHPeraorHt 6eadrot s6*ePdgroiovser nPgrivoneHpnereianvrtipo6ruedsvoi5so-eu7sgmi5vo-e7nntmhinso.nptrhesv.ious 5-7 months.

NeNwemwemdiecdailcdailadginaogsneosseas a%s %of otofttaoltcaalsceasses

191.49%.4%(31(351/15,/612,62) 6)

*Prior ProHeart 6 dose given in previous 5-7 months. *Pr*iPoriPoroPHroeHareta6rtd6osdeogseivgeinvein pinrepvrieovuisou5s-75m-7omntohnst.hs.

Additional services and

TABTLAEB2L:EA2D: DAIDTTADIOBITNLIEOAN2L:ASALEDRSDVEIITRCIVEOISNCEOASBLTOSABEIRTNAVEIDNCESDOBTAINED TABTLAEB3L:EA3D: DAIDTTADIOBITNLIEOAN3L:APALRDOPDDRITUOICDOTUNSCATOLSBPTORABOITNDAUEIDNCTESDOBTAINED

products obtained

BYBCYLICENLITESNTASBT YAPTRCOLPIHREEONAHTRESTAAR6TTSPE6RCSOOEHNCEODANRVDTISV6ITISSEITCONDTAVBISLEIT2: BAYDBDCYILTICIEONLNITEASNLTASSBTEYAPRTRCVOLPICIHREEEONSAHTORESTBAATR6TATSPIEN6RCESOODEHNCEODANRVDTISV6ITISSEITCONDTAVBISLEIT3:

The ProHeart 6 second-dose visit alsoSesraSvweicrevi1ce1

ServiceI1NnvooI.Nni(cv%ooe.)is(c%e)s

MNoeM.a(n%ea)n CInhvaCorhgicaeergse

78.9% of clients (1,283/1,626) obtaining

VaccVinacactiionnastions Vaccination3s79 3(7293)(23) $33769.$3(3263.)33

other products, services or both. Tables 2 HearHtweaorrtmwotermstitnegsHtinegartworm2t9e7st2i(n91g78)(18) $22997.$0(2198.)01

CM$BSh3aeeY6rr.a3gCvTBSn3iAeLeYcTBSIBrAeEeYCvL1NBriLEcCvPPILTieEeLr2EcSt1IoN:eEsPP2duAAT1Ne:rputTSDopATscldDuPiSDAtepuRIsTDpTAclOiIPtTeTOHsRIPNIEOONnRAAPPNvHoOeRroLAIt.EoHNnTis(SALcdu%IvEoNn6pEeuRoSA.p)vRscoSTilE(RociV%t.eER6Ties(IcCV%)CsS6eOIE)ECsSNSCICE1MnENDhO7SOvC5aoeNoIBVOCO1nr.a(MNig71IDThNc(vBnCS51%oAeMaoee)DThIV.(rIiaTs)A1aeNcg(I1Vn1%SrIaee)ENgInsS)TDeE1ITDCI1MnNh$7v25aoeoC3Mr.a(.ih$71gc(n271a%eee3)ra.s)7gn17eBPrYoCdTBPCMAuLrYh$TBPoIc2BaeAErY3CdtroLa.NBuL7gECdn

$V2a9c.c0i1nationsFleaFcloenatcrolntrol 3F7l9ea(2c3o)ntrol 1$43061.34(309) (9) 1$4307.$6(3697).66 Pet sup$p3li7e.s6

and 3 show these additional servicesFeacanFletdceastlitnegsting Fecal testin2g75 2(7157)(17) $23725.$3(31527.)35

VaVccaicncaitniaotnios ns

37397(923(2) 3)

$3$63.363.33

PePt seut psup

$H3e2a.r3t5worm tFelsetainF/tgliecak/tciockntcrolnt2roF9ll7ea(/1t8ic)k control 1$32591.03(158) (8) 1$358.$5(5988).59 Flea co$n5tr8o.5l

products, as well as the mean chargBeloofBdolowroodrkwork Blood work101 10(16) (6)

each item. Vaccinations were the mBooarBsdoitnagrding Boarding 86 8(65) (5) common additional services (23.3%NailoNtrafiiml trim Nail trim 81 8(15) (5) invoices, mean charge $36.33), andSurpgSeeuryrtgery Surgery 64 6(4) (4)

AnaAl snaacl esxapcreexspsiroenAssnioanl sac exp5r6ess5i(o63n) (3)

supplies were the most common additAinoenAsthnaelsitahesia Anesthesia 53 5(3) (3)

$18031.$187(36.)17 $9806.$490(05.)40 $1821.$217(25.)27 $1648$.116(48).11 $1546.$412(43.)42 $583.$051(83.)01

$F8e3c.a1Hl7teeHasrteitanwrgtoAwrnmotriAmtbeinsotttetiiibnsctigsiontgics 2A75nt(2i1b97i27o)9t(i71cs8(1) 8) 1$23121.3$2(5217$9) 2.0(971.)01

$B9lo0o.4Fd0ewFcaeolcrktaelAsttelilnsetgAringlgyletrrgeyattmreeantmt1eA0n1ltle2r(7g625y)7(t5r1e7(a1)tm7)ent$7843.1$7(7345$2) 3.3(255.)35

$B1o2a.r2Bd7ilnoBgolodowdNowSrkAoNrIkDSAs IDs

N86SA1(0I5D1)0s1(6)(6) $7940.4$7(0845$3) 8.1(357.)17

$N16a8il.1Bt1roiBmarodairndDginiegtDariyetary

D81ieta(8r56y)86(5)(5) $7102.2$7(7904$0) 9.4(040.)40

NaNilatirlimtrim

8181(5)(5)

$1$21.227.27

$S1u4rg.4e2ry IntesItnitneasltipnaarlapsiatriacsiI6dint4eitcseisd(ti4ens)al parasiti$c12id65e8s.12(152) (2)

$A5n8a.l0Ss1uaSrcgueerxrgypeMrreyesdsMioceandtiiocnatrieofnilrlsefMi5l6lsedi(6c34a)6ti4o(n4)(r4ef)ills$2124$.421(221$6)186.(1811.)11

1$2319.$2(3079).20 Flea/Ftilce$Fka3le9ccao.o2nnc $7344.$1(3854).18 AntibFiloe$Fta3il/ce4tsai.c1/tk $7343.$7(3653).76 AllerAgyn$At3tirnb3eti.aio7btt $7301.$4(3641).46 NSAAIDl$Alse3lr1lge.y4rg

NSNASIADIs $2151.$9(1021).90 Dietary$11.9 $229.$9(2719).97 IntesDtini$Dea2tlia9epr.ty9aar

products (10.8% of invoices, mean chEaarrtEgreaearttmreeantmt ent Ear treatmen3t9 3(92) (2) $2359.$329(52.)39

$A2n5e.s3At9hneAaslniasaalScsahecaxmpSexrhpepaosrmoseisposonioon S5h3am(53p6)o5o6(3)(3) $1538(.0 ................
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