ProHealth me-cfs 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

Happiness, Gratitude and Appreciation

New clinical research program to combat chronic pain and chronic fatigue syndrome

It’s Still a Wonderful Life

Lack of Knowledgeable Healthcare Access for Patients with Neuro-endocrine-immune Diseases

Survey Data on Name Change for ME/CFS Analyzed for Publication

Assessment of activity limitations and participation restrictions with persons with chronic fatigue ...

Help the National ME/FM Action Network win $5000!

Shake That *^#&! ing Stigma – The “Shake the CFS Stigma Challenge” Begins

Now Is the Time for a National PR Campaign for ME/CFS!

US Disabled Hold Protests at Bethesda

 
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

Save on Nutritional Supplement Orders

Featured Products

Hydroxocobalamin Extreme™ Hydroxocobalamin Extreme™
The B-12 your brain needs for detox & sharpness
Ultra ATP+, Double Strength Ultra ATP+, Double Strength
Get energized with malic acid & magnesium
MitoQ® MitoQ®
Powerful Antioxidant Support to Mitochondria
B-12 Extreme™ B-12 Extreme™
The Most Potent Vitamin B-12 on Earth
Energy NADH™ 12.5mg Energy NADH™ 12.5mg
Improve Energy & Cognitive Function

Natural Remedies

Are You Obtaining the Proper Enzymes? Are You Obtaining the Proper Enzymes?
More Weight Loss than Any Other Discovery in Supplement History More Weight Loss than Any Other Discovery in Supplement History
The Brain Boosting and Fatigue Fighting B-12 The Brain Boosting and Fatigue Fighting B-12
Could a B-12 Deficiency Be Causing Your Symptoms? Could a B-12 Deficiency Be Causing Your Symptoms?
Undenatured Type II Collagen - Chicken Soup for Your Joints Undenatured Type II Collagen - Chicken Soup for Your Joints

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