Comparing healthcare costs of Medicaid patients with postherpetic neuralgia (PHN) treated with lidocaine patch 5% versus gabapentin or pregabalin

Abstract

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.

Limitations:

Findings are based on a Medicaid sample and may not be generalizable to all PHN patients.

Key words::

• Cost
• Gabapentin
• Lidocaine patch
• Postherpetic neuralgia (PHN)
• Pregabalin

Transparency

Declaration of funding

This study was funded by Endo Pharmaceuticals, Inc.

Declaration of financial/other relationships

N.K., H.G.B., R.W., E.K., and J.I.I. have disclosed that they are employed by Analysis Group, Inc., a company that received financial support from Endo Pharmaceuticals to conduct this study. R.A.P., R.H.B-J., and K.H.S. have disclosed that they are employees of Endo Pharmaceuticals, Inc.

Acknowledgments

The authors wish to thank Dr Stephen Camper of Endo Pharmaceuticals, Inc. for his assistance in manuscript preparation and review.

Material from this study was presented as a poster at AMCP’s 22nd Annual Meeting & Showcase, San Diego Convention Center, San Diego, CA, April 7–10, 2010, under the title: ‘Economic value of lidocaine patch 5% vs. gabapentin or pregabalin in Medicaid patients with postherpetic neuralgia’.

Notes

* Kirson et al. Descriptive analysis of Medicaid patients with postherpetic neuralgia treated with lidocaine patch 5%, pp. 472-481 of this issue.