title: Identification of patients with painful diabetic peripheral neuropathy who have a favorable cost profile with pregabalin treatment.
abstract: OBJECTIVE
  To characterize patient populations with favorable costs after the initiation of pregabalin for the treatment of painful diabetic peripheral neuropathy (pDPN) relative to duloxetine, gabapentin, and amitriptyline.
  
  
  METHODS
  Patients were identified from MarketScan having ≥ 1 claim for pDPN (ICD-9-CM codes 250.6 or 357.2) within 60 days of first prescription (index) for pregabalin, duloxetine, gabapentin, or amitriptyline in 2008 and continuous enrollment 12 months pre- and postindex. Pregabalin patients were propensity-score-matched to each comparator. Using cutoff values ≥ 80% proportion of days covered (PDC) and ≥ 65 years for age, pre- to postindex changes in healthcare costs were estimated for pregabalin vs. comparators.
  
  
  RESULTS
  Of 987 patients initiated on pregabalin, 349 matched to duloxetine; 987 to gabapentin; 276 to amitriptyline. The pre- to postindex changes in total healthcare costs were similar between cohorts: $3272 with pregabalin vs. $2290 with duloxetine (P = 0.5280); $3687 with pregabalin vs. $5498 with amitriptyline (P = 0.5863); $3869 with pregabalin vs. $4106 with gabapentin (P = 0.8303). For the high-age/high-PDC population, the pre- to postindex differences in mean total costs were significantly lower with pregabalin (P < 0.001) relative to comparators ($3573 vs. $8288 for duloxetine; $1423 vs. $3167 for gabapentin; $2285 vs. $6160 for amitriptyline).
  
  
  CONCLUSIONS
  The association of lower total costs among older individuals with pDPN who maintain high adherence to pregabalin therapy relative to key comparators suggests a pharmacoeconomic advantage of pregabalin in this population combined with a need for strategies promoting adherence.
authors.affiliation: Pfizer Inc., 235 East 42nd Street, New York, NY 10017, U.S.A. Margarita.Udall@pfizer.com
authors.forename: Margarita
authors.initials: M
authors.lastname: Udall
authors.forename: Jack
authors.initials: J
authors.lastname: Mardekian
authors.forename: Javier
authors.initials: J
authors.lastname: Cabrera
mesh_terms: D000368:Aged; D000700:Analgesics / Q000191:economics* / Q000627:therapeutic use; D015331:Cohort Studies; D003929:Diabetic Neuropathies / Q000188:drug therapy / Q000191:economics*; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D000069583:Pregabalin; D012189:Retrospective Studies; D016896:Treatment Outcome; D005680:gamma-Aminobutyric Acid / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use
chemical_list: D000700:Analgesics; D000069583:Pregabalin; D005680:gamma-Aminobutyric Acid