ProHealth fibromyalgia Vitamin and Natural Supplement Store and Health
Home  |  Log In  |  My Account  |  View Cart  View Your ProHealth Vitamin and Supplement Shopping Cart
800-366-6056  |  Contact Us  |  Help

|
|
|

Trending News

Piriformis Syndrome in Fibromyalgia

Sensory Distress: The Other Side of Fibromyalgia

Patient Harm: The Facts and the Effects of Fibromyalgia Diagnostic Criteria

Small Fiber Neuropathy Fibromyalgia Studies Mount: But Does SFN Cause Pain in FM?

Cognitive Dysfunction of Fibromyalgia Does Not Impair Driving Ability

The Functional Capacity Evaluation (FCE) and Your Disability Insurance Benefits

Study Finds Serotonin Decreases Sensitivity to Pain

SURVEY RESULTS: Cognitive Impairment

Novel Fibromyalgia Treatment Shows Promise in Study

Connectivity Between Brain Regions May Predict Fibromyalgia Drug Treatment Response

 
Print Page
Email Article

Impact of a Pregabalin Step Therapy Policy Among Medicare Advantage Beneficiaries

  [ 1 vote ]   [ Discuss This Article ]
By Brandon T. Suehs PharmD, PhD, et al. • www.ProHealth.com • May 26, 2013


Abstract:

BACKGROUND: Managed healthcare organizations often utilize formulary management strategies such as prior authorization and step therapy to guide appropriate medication use and to control medication expenditures. The objective of this study was to examine clinical and economic outcomes associated with implementation of a pregabalin step therapy (ST) policy among Medicare Advantage Prescription Drug (MAPD) members.

METHODS: Pharmacy and medical claims data from Humana (restricted cohort; ST policy implemented 01/01/2009) and Thomson Reuters MarketScan® (unrestricted cohort) were analyzed for MAPD members aged 65 to 89  years receiving treatment for painful diabetic peripheral neuropathy (pDPN), postherpetic neuralgia (PHN) or fibromyalgia (FM). Difference-in-differences (DID) was used to examine year-over-year changes in disease-related and all-cause utilization and costs. Regression analyses examined medication utilization and healthcare expenditures after controlling for between-group compositional differences.

RESULTS: We identified 13,911 members in the restricted cohort and matched to members from unrestricted health plans. FM (51.0%) and pDPN (41.8%) were the most common diagnoses. Members in the unrestricted cohort were older and had a greater level of comorbidity than members in the restricted cohort. The restricted cohort demonstrated greater year-over-year decrease in pregabalin utilization and increase in year-over-year gabapentin utilization compared with the unrestricted cohort. ST restriction was associated with an increase in disease-related pharmacy costs and a decrease in total medical costs for the restricted cohort compared with the unrestricted cohort. There was no difference between cohorts in total healthcare cost.

CONCLUSION: After controlling for differences in age and comorbidity burden between the groups, implementation of a pregabalin ST restriction was associated with increased disease-related pharmacy costs and decreased total medical costs; however, there was no net difference in total healthcare cost or total pharmacy cost.

Source: Pain Practice, May 23, 2013. By Brandon T. Suehs PharmD, PhD, Anthony Louder RPh, PhD, Margarita Udall MPH, Joseph C. Cappelleri MPH, PhD, Ashish V. Joshi PhD, and Nick C. Patel PharmD, PhD. Competitive Health Analytics Inc., Louisville, Kentucky, U.S.A.




Please Discuss This Article:   Post a Comment 



[ Be the first to comment on this article ]




 
Free Chronic Fatigue Syndrome and Fibromyalgia Newsletters
Subscribe to
Our FREE
Newsletter
Subscribe Now!
Receive up-to-date ME/CFS & Fibromyalgia treatment and research news
 Privacy Guaranteed  |  View Archives

Save on Immune Support Supplements

Featured Products

Energy NADH™ 12.5mg Energy NADH™ 12.5mg
Improve Energy & Cognitive Function
B-12 Extreme™ B-12 Extreme™
The Most Potent Vitamin B-12 on Earth
Fibro Freedom™ Fibro Freedom™
Soothes, strengthens & revitalizes
FibroSleep™ by ProHealth FibroSleep™ by ProHealth
The All-in-One Natural Sleep Aid
Guaifenesin FA™ Guaifenesin FA™
Natural Expectorant Relieves Chest Congestion

Natural Remedies

VIDEO: Healthy Eating and Fibromyalgia VIDEO: Healthy Eating and Fibromyalgia
Shoo Pain, Don't Bother Me - Top 10 Nutrients to Take Back Your Life Shoo Pain, Don't Bother Me - Top 10 Nutrients to Take Back Your Life
Broad Spectrum Protection Against Brain Aging Broad Spectrum Protection Against Brain Aging
The Big Blue Fish that Helps Chase the Blues Away The Big Blue Fish that Helps Chase the Blues Away
Running on Empty? Fuel Up with NADH Running on Empty? Fuel Up with NADH

FIBROMYALGIA RESOURCES
What is Fibromyalgia?
Fibromyalgia 101
Fibromyalgia Symptoms
Fibromyalgia Treatments
| CFS RESOURCES
What is CFS?
ME/CFS 101
ME/CFS Symptoms
ME/CFS Treatments
| FORUMS
Fibromyalgia
ME/CFS
ADVANCED MEDICAL LABS
WHOLESALE  |  AFFILIATES
GUARANTEE
CONTACT US
PRIVACY
RSS
SITE MAP
ProHealth on Facebook  ProHealth on Twitter  ProHealth on Pinterest  ProHealth on Google Plus
Credit Card Processing