Clinical and economic consequences of treating patients with peripheral neuropathic pain with brand name or generic drugs in routine clinical practice: The effects of age and sex.
OBJECTIVE
We aimed to analyse the effects of age and sex on pain and cost for patients with chronic peripheral neuropathic pain (PNP) who have started treatment with brand name gabapentin versus generic gabapentin (EFG).


METHODS
We conducted a retrospective multicentre study using electronic medical records (EMR) for patients of both sexes, older than 18, who began treatment with brand name or generic gabapentin. Adherence (medication possession ratio [MPR]), persistence, use of healthcare resources, cost, and pain reduction were measured for one year.


RESULTS
We analysed 1369 EMRs [61.1% women; mean age 64.6 (15.9), 52.4%≥65 years]; 400 used brand name drugs while 969 used generic gabapentin. Persistence and adherence were higher in patients using brand name gabapentin (7.3 vs 6.3 months, P<.001; 86.5% vs 81.3% MPR, P<.001). Lower healthcare costs were observed in patients using brand-name gabapentin in both age groups (<65 and ≥65). Mean difference in cost per patient amounted to €221 (95%CI: 59-382) and €217 (95%CI: 51-382) in the <65 and ≥65 age groups, respectively (P<.01). Mean difference in cost among men amounted to €197 (63-328), while mean difference in cost among women amounted to €239 (96-397) (P=.005 and P=.004, respectively). Compared with EFG, brand treatment showed greater pain relief: 13.5% (10.9-16.2) and 10.8% (8.2-13.5) in <65 and ≥65year patients, respectively (P<.001), and 10.7% (8.2-13.2) and 13.8% (11.0-16.5) in women and men respectively (P<.001).


CONCLUSIONS
Regardless of sex and age, patients who started PNP treatment with brand name medication showed greater persistence and adherence to treatment than those taking generic drugs. Brand name treatment also involved lower healthcare costs, and greater pain relief.
Documentación Médica, Hospital Germans Trias i Pujol, Badalona, Barcelona, España.
R
R
Navarro-Artieda
Farmacoeconomía e Investigación de Resultados en Salud, Pfizer SLU, Alcobendas, Madrid, España. Electronic address: Javier.rejas@pfizer.com.
J
J
Rejas-Gutiérrez
Departamento Médico, Pfizer GEP SLU, Alcobendas, Madrid, España.
M
M
Pérez-Paramo
CAP Vicenç Papaciet, La Roca del Vallès, Barcelona, España.
A
A
Sicras-Mainar
D000368:Aged; D000588:Amines / Q000191:economics / Q000627:therapeutic use*; D000700:Analgesics / Q000627:therapeutic use*; D003509:Cyclohexanecarboxylic Acids / Q000191:economics / Q000627:therapeutic use*; D016568:Drugs, Generic / Q000191:economics*; D005260:Female; D000077206:Gabapentin; D006801:Humans; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000188:drug therapy* / Q000191:economics*; D012189:Retrospective Studies; D005680:gamma-Aminobutyric Acid / Q000191:economics / Q000627:therapeutic use*
D000588:Amines; D000700:Analgesics; D003509:Cyclohexanecarboxylic Acids; D016568:Drugs, Generic; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin
Adherence; Adherencia; Brand name drugs; Costes; Costs; Dolor neuropático; Gabapentin; Gabapentina; Generic drugs; Genéricos; Medicamentos de marca; Neuropathic pain