title: Treatment patterns of postherpetic neuralgia patients before and after the launch of pregabalin and its effect on medical costs: Analysis of Japanese claims data provided by Japan Medical Data Center.
abstract: Except for neurotrophin, no drug had an indication for postherpetic neuralgia (PHN) in Japan prior to pregabalin approval. This approval might have changed PHN treatment patterns. This study aimed to compare PHN treatment patterns and medical costs between patients who started treatment before and after pregabalin approval. Japanese claims data were used to identify patients aged 18 years or more with PHN, postherpetic trigeminal neuralgia or postherpetic polyneuropathy who were initiated on their first PHN-associated prescription through May 2010 (before approval) or from June 2010 (after approval). From these claims, 6-month treatment patterns from first prescription were compared for the periods before and after approval. These patterns included pain-related medications and the frequency of pain-relief procedures. All-cause and pain-related medical costs were also compared for these periods. The number of PHN patients who were initiated on treatment before and after approval were 107 (mean age, 47.4 ± 13.0 years) and 505 (45.9 ± 13.0), respectively. Post-approval, significant reductions were observed for prescription of non-steroidal anti-inflammatory drugs, tricyclic antidepressants and neurotrophin relative to before approval. Excluding pregabalin acquisition costs, mean costs per patient for medications associated with PHN for 6 months from the first prescription were significantly lower after approval, ¥2882 vs ¥4185. Total medical costs were similar in both periods. Approval of pregabalin appeared to result in a treatment paradigm toward use of an approved therapy with demonstrated efficacy.
authors.affiliation: Dr Mariko Skin and Dermatology Clinic, Yokohama, Japan.
authors.forename: Mariko
authors.initials: M
authors.lastname: Honda
authors.affiliation: Crecon Medical Assessment, Tokyo, Japan.
authors.forename: Tatsunori
authors.initials: T
authors.lastname: Murata
authors.affiliation: Pfizer Japan, Tokyo, Japan.
authors.forename: Nozomi
authors.initials: N
authors.lastname: Ebata
authors.affiliation: Pfizer Japan, Tokyo, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Fujii
authors.affiliation: Nihon University Research Center, Tokyo, Japan.
authors.forename: Setsuro
authors.initials: S
authors.lastname: Ogawa
mesh_terms: D000067575:Administrative Claims, Healthcare / Q000191:economics / Q000706:statistics & numerical data*; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000191:economics / Q000627:therapeutic use; D000929:Antidepressive Agents, Tricyclic / Q000191:economics / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D017277:Drug Approval / Q000191:economics; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006562:Herpes Zoster / Q000150:complications* / Q000191:economics / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009414:Nerve Growth Factors / Q000191:economics / Q000627:therapeutic use; D051474:Neuralgia, Postherpetic / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology; D010818:Practice Patterns, Physicians' / Q000191:economics / Q000706:statistics & numerical data; D000069583:Pregabalin / Q000191:economics / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000929:Antidepressive Agents, Tricyclic; D002121:Calcium Channel Blockers; D009414:Nerve Growth Factors; D000069583:Pregabalin
keywords: Japan; claims data analysis; postherpetic neuralgia; practice patterns; pregabalin