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

|
|
|

Trending News

Protecting Your Fibromyalgia Window of Well

Lidocaine Injections Found to Reduce Hypersensitivity to Pain in Fibromyalgia Patients

Autoimmune Research Opening Up New Options for Chronic Pain Sufferers

Is Hyper-parathyroidism Sometimes Misdiagnosed as Fibromyalgia?

Celiac Symptoms in Fibromyalgia Patients

VIDEO: Ribose Helps Fight Fibromyalgia

Prevalence of falls in fibromyalgia patients

SURVEY RESULTS: Patient Experience with Doctors

Melatonin Improves Pain in Fibromyalgia

Study Answers Question: Why Are Physicians Resistant to Accepting Fibromyalgia Patients?

 
Print Page
Email Article

Does Using a Step Therapy Program for Pregabalin Reduce Healthcare Costs?

  [ 1 vote ]   [ Discuss This Article ]
www.ProHealth.com • April 28, 2013


Editor's comment:  Step Therapy is a term used to describe a practice used by many insurance companies that requires physicians to begin drug therapy for a medical condition with the most cost-effective and safest drug therapy available, progressing to other more costly or risky therapy, only if necessary.  This practice is sometimes called Fail First because patients must try and fail to be helped by all of the less costly medications available before the insurance company will pay for a more expensive (usually brand-name) medication.  This study compares two groups of patients whose doctors wanted to prescribe pregabalin (Lyrica) for them.  One group was restricted to using the Step Therapy approach while the other group was unrestricted, meaning their doctors could prescribe pregabalin for them without having to try other medications first.  The objective of the study was to find out whether the Step Therapy approach was ultimately less expensive overall than an unrestricted approach.

Impact of a step-therapy protocol for pregabalin on healthcare utilization and expenditures in a commercial population.

By Margarita Udalla, et al.

Abstract:

Objective:
To compare changes in healthcare resource utilization and costs among members with painful diabetic peripheral neuropathy (pDPN), postherpetic neuralgia (PHN), or fibromyalgia (FM) in a commercial health plan implementing pregabalin step-therapy with members in unrestricted plans.

Methods:
Retrospective study of outcomes associated with implementation of a pregabalin step-therapy protocol using claims data from Humana ('restricted' cohort) and Thomson Reuters MarketScan ('unrestricted' cohort). Members aged 18-65 years receiving treatment for pDPN, PHN, or FM during 2008 or 2009 were identified; cohorts were matched on diagnosis and geographic region. Baseline to follow-up changes in healthcare resource utilization and costs were determined using difference-in-differences (DID) analysis. Statistical models adjusting for covariates explored relationships between restricted access and outcomes.

Results: A total of 3876 restricted cohort members were identified and matched to 3876 unrestricted cohort members. FM was the predominant diagnosis (84.7%). The unrestricted cohort was older (mean = 49.0 (SD = 10.4) years vs 47.6 (SD = 10.5) years; p < 0.001), and had greater comorbidity (RxRisk-V score = 5.4 (SD = 3.2) vs 4.4 (SD = 2.9), p < 0.001) than the restricted cohort.

  • Compared with the unrestricted cohort, the restricted cohort demonstrated a greater year-over-year decrease in pregabalin utilization (-2.6%, p = 0.008), and greater increases in physical therapy and disease-related outpatient utilization (3.7%, p = 0.010 and 3.6%, p = 0.022, respectively).

  • There were no statistically significant net differences in all-cause or disease-related total healthcare, medical, or pharmacy costs between cohorts.

  • After adjusting for baseline compositional differences between cohorts, restricted plan membership was associated with a net increase in all-cause medical ($1222; p = 0.016) and disease-related healthcare costs ($859; p = 0.002).

Limitations include use of a combined analysis for pDPN, PHN, and FM, especially since the observed results were likely driven by FM; an inability to link the prescribing of a medication with the condition of interest, which is common to claims analyses; and lack of pain severity information.

Conclusions: Implementation of a pregabalin step-therapy protocol resulted in lower pregabalin utilization, but this restriction was not associated with reductions in total healthcare costs, medical costs, or pharmacy costs.

Source:  Journal of Medical Economics, Epub April 26, 2013. By Margarita Udalla, Anthony Louderb, Brandon T. Suehsb, Joseph C. Cappelleria, Ashish V. Joshic and Nick C. Patel. Pfizer Inc , New York, NY , USA.



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

Immune Support Supplements

Featured Products

Fibro Freedom™ Fibro Freedom™
Soothes, strengthens & revitalizes
Energy NADH™ 12.5mg Energy NADH™ 12.5mg
Improve Energy & Cognitive Function
Guaifenesin FA™ Guaifenesin FA™
Natural Expectorant Relieves Chest Congestion
Optimized Curcumin Longvida® by ProHealth Optimized Curcumin Longvida® by ProHealth
Supports Cognition, Memory & Overall Health
B-12 Extreme™ B-12 Extreme™
The Most Potent Vitamin B-12 on Earth

Natural Remedies

The Revolutionary 'Good Fat' That Promotes Heart, Brain, Bone and Joint Health The Revolutionary 'Good Fat' That Promotes Heart, Brain, Bone and Joint Health
Repair Damaged Mitochondria and Reduce Fatigue Up to 45% Repair Damaged Mitochondria and Reduce Fatigue Up to 45%
IBS, Crohn’s Disease, Colitis, and Other Digestive Disorders IBS, Crohn’s Disease, Colitis, and Other Digestive Disorders
Green Coffee Extract: Unique Obesity Intervention Green Coffee Extract: Unique Obesity Intervention
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