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
Facebook Google Plus
Fibromyalgia  Chronic Fatigue Syndrome & M.E.  Lyme Disease  Natural Wellness  Supplement News  Forums  Our Story
Store     Brands   |   A-Z Index   |   Best Sellers   |   New Products   |   Deals & Specials   |   Under $10   |   SmartSavings Club

Trending News

Orthostatic Intolerance, Part 1: Diagnosing OI

Yes, It Really Is Possible to Restore Mitochondrial Function!

Is Searching for THE Answer Making You Worse?

The Cure for Giving Up (When it Feels Like Chronic Pain Is Forever)

Orthostatic Intolerance, Part 2: Treating OI

Metabolomics Study Points Finger at Energy Production in Fibromyalgia

Gather Your Tribe

Horror to Hope: Grief to Action

Cellular Energy Production Takes Big Hit in Chronic Fatigue Syndrome (ME/CFS) Study

Cellular bioenergetics is impaired in patients with chronic fatigue syndrome

 
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?

  • 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.




Post a Comment

Featured Products From the ProHealth Store
MitoQ® Mitochondria Ignite™ with NT Factor® Ultra ATP+, Double Strength


Article Comments



Be the first to comment on this article!

Post a Comment


 
Optimized Curcumin Longvida with Omega-3

Featured Products

Energy NADH™ 12.5mg Energy NADH™ 12.5mg
Improve Energy & Cognitive Function
Ultra ATP+, Double Strength Ultra ATP+, Double Strength
Get energized with malic acid & magnesium
B-12 Extreme™ B-12 Extreme™
The Most Potent Vitamin B-12 on Earth
Hydroxocobalamin Extreme™ Hydroxocobalamin Extreme™
The B-12 Your Brain Needs for Detox & Sharpness
Mitochondria Ignite™ with NT Factor® Mitochondria Ignite™ with NT Factor®
Reduce Fatigue up to 45%

Natural Remedies

The Curcumin Revolution: 'Golden' Ticket to Better Health The Curcumin Revolution: 'Golden' Ticket to Better Health
Strengthen Cell Function with Energy-Boosting Niagen Strengthen Cell Function with Energy-Boosting Niagen
Herbal Inflammation Management for Whole Body Health Herbal Inflammation Management for Whole Body Health
Live Without Anxiety or Stress Live Without Anxiety or Stress
Aches and Pains? A Simple Solution You'll Love Aches and Pains? A Simple Solution You'll Love

CONTACT US
ProHealth, Inc.
555 Maple Ave
Carpinteria, CA 93013
(800) 366-6056  |  Email

· Become a Wholesaler
· Vendor Inquiries
· Affiliate Program
SHOP WITH CONFIDENCE
Credit Card Processing
SUBSCRIBE TO OUR NEWSLETTERS
Get the latest news about Fibromyalgia, M.E/Chronic Fatigue Syndrome, Lyme Disease and Natural Wellness

CONNECT WITH US ProHealth on Facebook  ProHealth on Twitter  ProHealth on Pinterest  ProHealth on Google Plus

© 2017 ProHealth, Inc. All rights reserved. Pain Tracker App  |  Store  |  Customer Service  |  Guarantee  |  Privacy  |  Contact Us  |  Library  |  RSS  |  Site Map