Analysis Group, Inc., Boston, MA 02199, USA.
J Med Econ. 2010;13(3):482-91. doi: 10.3111/13696998.2010.506176.
To compare healthcare resource utilization and costs of postherpetic neuralgia (PHN) patients initiating lidocaine patch 5% (lidocaine patch) or oral gabapentin/pregabalin.
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.
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.
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.
Findings are based on a Medicaid sample and may not be generalizable to all PHN patients.
比较带状疱疹后神经痛（PHN）患者使用利多卡因贴剂 5%（利多卡因贴剂）或口服加巴喷丁/普瑞巴林的医疗资源利用和成本。
从佛罗里达州、爱荷华州、密苏里州和新泽西州的 1999 年至 2007 年医疗保险索赔数据中选择 PHN 诊断或带状疱疹诊断和≥30 天 PHN 推荐治疗的患者。在 PHN 诊断后，患者开始接受单药治疗利多卡因贴剂或加巴喷丁/普瑞巴林，在药物索引日期前 6 个月（基线期）和后 6 个月（研究期）内连续有资格，并≥18 岁。根据开始治疗的倾向，将利多卡因贴剂患者与加巴喷丁/普瑞巴林患者进行匹配。使用单变量分析比较两组治疗期间从医疗补助角度来看的资源利用和成本。
匹配患者的平均年龄为 61.3 岁，约 73%为女性，55%在基线期患有其他疼痛性疾病。6 个月每位患者的 PHN 相关处方药费用在匹配的利多卡因贴剂（n=312）和加巴喷丁/普瑞巴林（n=312）患者中相似（854 美元对 820 美元，p=0.75），而利多卡因贴剂组的 PHN 相关医疗费用较低（145 美元对 353 美元，p=0.12）。此外，在观察期内，两组患者的总体资源利用、总处方药费用和每位患者的总医疗费用没有统计学上的显著差异。
尽管利多卡因贴剂的标价较高，但在 6 个月的研究期间，PHN 患者使用利多卡因贴剂的总体医疗成本不高于使用加巴喷丁或普瑞巴林的患者。该研究表明，利多卡因贴剂患者的 PHN 相关医疗费用可能较低。
研究结果基于医疗补助样本，可能不适用于所有 PHN 患者。
