Comparing healthcare costs of Medicaid patients with postherpetic neuralgia (PHN) treated with lidocaine patch 5% versus gabapentin or pregabalin.
OBJECTIVE
To compare healthcare resource utilization and costs of postherpetic neuralgia (PHN) patients initiating lidocaine patch 5% (lidocaine patch) or oral gabapentin/pregabalin.


METHODS
Patients with PHN diagnosis, or herpes zoster diagnosis and ≥30 days PHN-recommended treatment were selected from de-identified Medicaid claims data from Florida, Iowa, Missouri, and New Jersey, 1999-2007. Patients initiated monotherapy with lidocaine patch or gabapentin/pregabalin after PHN diagnosis, had continuous eligibility 6 months before (baseline) and 6 months after (study period) medication index date, and were ≥18 years old. Lidocaine patch patients were matched to gabapentin/pregabalin patients based on their propensity to initiate treatment. Study period resource utilization and costs from a Medicaid perspective were compared between treatment groups using univariate analysis.


RESULTS
Matched patients were on average 61.3 years old, approximately 73% were women, and 55% had other painful conditions during the baseline period. 6-month per patient PHN-related prescription drug costs were similar for matched lidocaine patch (n=312) and gabapentin/pregabalin (n=312) patients ($854 vs. 820, p=0.75), while PHN-related medical costs appeared lower in the lidocaine patch group ($145 vs. 353, p=0.12). Furthermore, there were no statistically significant differences between treatment groups during the observation period in overall resource utilization, total prescription drug costs, and total medical costs per patient.


CONCLUSIONS
In spite of higher list prices, PHN patients treated with lidocaine patch cost no more than patients treated with gabapentin or pregabalin in terms of overall healthcare costs over the 6-month study period. The study suggests that PHN-related medical costs may be lower among lidocaine patch patients.


CONCLUSIONS
Findings are based on a Medicaid sample and may not be generalizable to all PHN patients.
Kirson
Noam Y
NY
Analysis Group, Inc., Boston, MA 02199, USA. nkirson@analysisgroup.com
Ivanova
Jasmina I
JI
Birnbaum
Howard G
HG
Wei
Robert
R
Kantor
Evan
E
Puenpatom
R Amy
RA
Ben-Joseph
Rami H
RH
Summers
Kent H
KH
D000588:Amines / Q000008:administration & dosage / Q000191:economics; D000700:Analgesics / Q000008:administration & dosage* / Q000191:economics*; D003365:Costs and Cost Analysis; D003509:Cyclohexanecarboxylic Acids / Q000008:administration & dosage / Q000191:economics; D005260:Female; D000077206:Gabapentin; D017048:Health Care Costs / Q000706:statistics & numerical data; D006296:Health Services / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007345:Insurance Claim Review; D008012:Lidocaine / Q000008:administration & dosage / Q000191:economics*; D008297:Male; D008484:Medicaid / Q000191:economics / Q000706:statistics & numerical data; D008875:Middle Aged; D051474:Neuralgia, Postherpetic / Q000188:drug therapy* / Q000191:economics*; D000069583:Pregabalin; D012189:Retrospective Studies; D057968:Transdermal Patch; D014481:United States; D005680:gamma-Aminobutyric Acid / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000191:economics
D000588:Amines; D000700:Analgesics; D003509:Cyclohexanecarboxylic Acids; D000069583:Pregabalin; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin; D008012:Lidocaine