Conversion from thrice- to twice-daily pregabalin dosing for pain: Economic and clinical outcomes in a veteran population.
OBJECTIVE
Results of a study analyzing economic and clinical outcomes one year after conversion from thrice- to twice-daily pregabalin dosing for pain are presented.


METHODS
A retrospective chart review was conducted at two Veterans Affairs facilities. The analyzed population included all patients receiving pregabalin for pain whose dosing was converted from thrice- to twice-daily pregabalin dosing during a one-year period. The primary endpoint was the economic impact of the conversion. Secondary endpoints included reversion to thrice-daily pregabalin dosing, pregabalin discontinuation, addition of medications for pain, and unscheduled neuropathy-related visits.


RESULTS
Among the 57 patients included in the data analysis, 41 continued to take pregabalin twice daily, 10 had pregabalin discontinued, and 6 had dosing reverted to thrice daily. The mean age of patients and the distribution of add-on pain medications did not differ significantly between patients whose pregabalin dosing frequency remained at twice daily and patients whose frequency reverted to thrice daily. The costs associated with pregabalin therapy differed significantly between the preconversion and postconversion periods. A savings of $115,867 was realized from this conversion for both facilities combined over the course of one year.


CONCLUSIONS
In patients receiving pregabalin for pain, conversion from thrice- to twice-daily pregabalin dosing-while maintaining the same daily dose-resulted in substantial cost savings while having little effect on clinical outcomes.
Chike Okolo, Pharm.D., is Oncology Pharmacist, Veterans Affairs Northern California Health Care System (VANCHCS), Sacramento; when this study was performed, he was Postgraduate Year 1 Pharmacy Practice Resident, VANCHCS. Robert Malmstrom, Pharm.D., and Karsten Duncan, Pharm.D., are Pharmacoeconomics Clinical Pharmacists; and Julio Lopez, Pharm.D., is Chief, Pharmacy Service Line, VANCHCS. chike.okolo@va.gov.
Chike
C
Okolo
Chike Okolo, Pharm.D., is Oncology Pharmacist, Veterans Affairs Northern California Health Care System (VANCHCS), Sacramento; when this study was performed, he was Postgraduate Year 1 Pharmacy Practice Resident, VANCHCS. Robert Malmstrom, Pharm.D., and Karsten Duncan, Pharm.D., are Pharmacoeconomics Clinical Pharmacists; and Julio Lopez, Pharm.D., is Chief, Pharmacy Service Line, VANCHCS.
Robert
R
Malmstrom
Chike Okolo, Pharm.D., is Oncology Pharmacist, Veterans Affairs Northern California Health Care System (VANCHCS), Sacramento; when this study was performed, he was Postgraduate Year 1 Pharmacy Practice Resident, VANCHCS. Robert Malmstrom, Pharm.D., and Karsten Duncan, Pharm.D., are Pharmacoeconomics Clinical Pharmacists; and Julio Lopez, Pharm.D., is Chief, Pharmacy Service Line, VANCHCS.
Karsten
K
Duncan
Chike Okolo, Pharm.D., is Oncology Pharmacist, Veterans Affairs Northern California Health Care System (VANCHCS), Sacramento; when this study was performed, he was Postgraduate Year 1 Pharmacy Practice Resident, VANCHCS. Robert Malmstrom, Pharm.D., and Karsten Duncan, Pharm.D., are Pharmacoeconomics Clinical Pharmacists; and Julio Lopez, Pharm.D., is Chief, Pharmacy Service Line, VANCHCS.
Julio
J
Lopez
D000700:Analgesics / Q000008:administration & dosage* / Q000191:economics / Q000627:therapeutic use; D003365:Costs and Cost Analysis; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy*; D000069583:Pregabalin / Q000008:administration & dosage* / Q000191:economics / Q000627:therapeutic use; D044469:Racial Groups; D012189:Retrospective Studies; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans
D000700:Analgesics; D000069583:Pregabalin