Margarita Udall

Impact of a Pregabalin Step Therapy Policy Among Medicare Advantage Beneficiaries

Managed healthcare organizations often utilize formulary management strategies such as prior authorization and step therapy to guide appropriate medication use and to control medication expenditures. The objective of this study was to examine clinical and economic outcomes associated with implementation of a pregabalin step therapy (ST) policy among Medicare Advantage Prescription Drug (MAPD) members.

Costs of pregabalin or gabapentin for painful diabetic peripheral neuropathy

Abstract Objective: To characterize and compare healthcare resource utilization and costs among patients with painful diabetic peripheral neuropathy (pDPN) newly prescribed pregabalin or gabapentin in a real-world clinical setting. Study Design: Retrospective cohort analysis using the MarketScan Commercial Claims and Encounters and Medicare Supplemental Databases (2007–2009). Methods: Patients with new prescriptions for pregabalin or gabapentin (index event) in 2008 and ≥1 healthcare encounter with an ICD-9 code for pDPN (250.6 or 357.2) within 30 days prior to the first prescription were identified and propensity score matched; continuous enrollment 12 months pre- and post-index was required. Pre- to post-index changes in 12-month all-cause and pDPN-attributable resource utilization and costs were compared between pregabalin and gabapentin using a difference-in-difference (DID) approach. Results: A total of 910 pregabalin patients (48.6% female; mean age 63.3 ± 12.1 years) were matched with 910 gabapentin patients (48.8% female; mean age 63.3 ± 12.1 years). The DID showed no significant differences between cohorts for pre- to post-index changes in any of the all-cause resource utilization categories. While prescription costs increased significantly more with pregabalin (DID −

Characteristics, Treatment, and Health Care Expenditures of Medicare Supplemental‐Insured Patients with Painful Diabetic Peripheral Neuropathy, Post‐Herpetic Neuralgia, or Fibromyalgia

563; p < 0.0001), the DID of

Impact of a step-therapy protocol for pregabalin on healthcare utilization and expenditures in a commercial population

1603 for total healthcare costs per patient indicated that the pre- to post-index increases of

PD-L1 diagnostic tests: a systematic literature review of scoring algorithms and test-validation metrics

3081 for pregabalin and

THU0321 Multisite Prospective Observational Study of Fibromyalgia Patients in the Us

4684 for gabapentin patients were comparable (p = 0.8474). Total pDPN-attributable healthcare costs were significantly higher with pregabalin (DID −

Cost comparison of drug–drug and drug–condition interactions in patients with painful diabetic peripheral neuropathy treated with pregabalin versus duloxetine

385; p < 0.0001), resulting from higher prescription costs (DID −

Progression of fibromyalgia: results from a 2-year observational fibromyalgia and chronic pain study in the US.

432; p < 0.0001). Limitations of this study include the inability to specifically link pDPN with medication prescribing; differences between groups despite propensity score matching; use of proxy measures for adherence parameters; and inability to capture efficacy outcomes. Conclusions: Among patients initiating pregabalin or gabapentin, there were no significant differences between the drugs in the pre- to post-index changes in all-cause total healthcare costs, despite the increase in prescription costs for pregabalin.

Fibromyalgia Outcomes over Time: Results from a Prospective Observational Study in the United States

OBJECTIVE To describe the characteristics, treatment, and health care expenditures of Medicare Supplemental-insured patients with painful diabetic peripheral neuropathy (pDPN), post-herpetic neuralgia (PHN), or fibromyalgia. DESIGN Retrospective cohort study. SETTING United States clinical practice, as reflected within a database comprising administrative claims from 2.3 million older adults participating in Medicare supplemental insurance programs. SUBJECTS Selected patients were aged ≥65 years, continuously enrolled in medical and prescription benefits throughout years 2008 and 2009, and had ≥1 medical claim with an International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code for DPN, PHN, or fibromyalgia, followed within 60 days by a medication or pain intervention procedure used in treating pDPN, PHN, or fibromyalgia during 2008-2009. OUTCOME MEASURES Utilization of, and expenditures on, pain-related and all-cause pharmacotherapy and medical interventions in 2009. RESULTS The study included 25,716 patients with pDPN (mean age 75.2 years, 51.2% female), 4,712 patients with PHN (mean age 77.7 years, 63.9% female), and 25,246 patients with fibromyalgia (mean age 74.4 years, 73.0% female). Patients typically had numerous comorbidities, and many were treated with polypharmacy. Mean annual expenditures on total pain-related health care and total all-cause health care, respectively, (in 2010 USD) were:

Potential drug-drug and drug-condition interactions among fibromyalgia patients initiating pregabalin or duloxetine: prevalence and health care expenditure impact.

1,632,