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From 2009 to 2014, the overall prescription rates of 5-ASAs declined from 42.9% to 30.0% (P less then 0.001). Patient factors independently associated with 5-ASA use included younger age, male sex, multimorbidity, and a health maintenance organization insurance plan, while controlling for the region of residence. Conclusions About 1 in 3 privately insured patients with CD received 5-ASA prescriptions despite their questionable effectiveness; however, in an encouraging trend, prescription rates significantly decreased from 2009 to 2014.