Pfizer, Inc., New York, NY 10017, USA.
J Med Econ. 2012;15(2):361-70. doi: 10.3111/13696998.2011.650773. Epub 2012 Jan 9.
To characterize and compare healthcare resource utilization and costs among patients with painful diabetic peripheral neuropathy (pDPN) newly prescribed pregabalin or gabapentin in a real-world clinical setting.
Retrospective cohort analysis using the MarketScan Commercial Claims and Encounters and Medicare Supplemental Databases (2007-2009).
Patients with new prescriptions for pregabalin or gabapentin (index event) in 2008 and ≥1 healthcare encounter with an ICD-9 code for pDPN (250.6 or 357.2) within 30 days prior to the first prescription were identified and propensity score matched; continuous enrollment 12 months pre- and post-index was required. Pre- to post-index changes in 12-month all-cause and pDPN-attributable resource utilization and costs were compared between pregabalin and gabapentin using a difference-in-difference (DID) approach.
A total of 910 pregabalin patients (48.6% female; mean age 63.3 ± 12.1 years) were matched with 910 gabapentin patients (48.8% female; mean age 63.3 ± 12.1 years). The DID showed no significant differences between cohorts for pre- to post-index changes in any of the all-cause resource utilization categories. While prescription costs increased significantly more with pregabalin (DID -$563; p < 0.0001), the DID of $1603 for total healthcare costs per patient indicated that the pre- to post-index increases of $3081 for pregabalin and $4684 for gabapentin patients were comparable (p = 0.8474). Total pDPN-attributable healthcare costs were significantly higher with pregabalin (DID -$385; p < 0.0001), resulting from higher prescription costs (DID -$432; p < 0.0001). Limitations of this study include the inability to specifically link pDPN with medication prescribing; differences between groups despite propensity score matching; use of proxy measures for adherence parameters; and inability to capture efficacy outcomes.
Among patients initiating pregabalin or gabapentin, there were no significant differences between the drugs in the pre- to post-index changes in all-cause total healthcare costs, despite the increase in prescription costs for pregabalin.
在真实临床环境中，对新处方普瑞巴林或加巴喷丁治疗疼痛性糖尿病周围神经病变（pDPN）患者的医疗资源利用情况和成本进行描述和比较。
使用 MarketScan 商业索赔和就诊数据库（2007-2009 年）进行回顾性队列分析。
2008 年新处方普瑞巴林或加巴喷丁（索引事件）的患者，且在首次处方前 30 天内有 ICD-9 编码为 pDPN（250.6 或 357.2）的≥1 次医疗就诊，经倾向评分匹配；要求在索引前和索引后连续 12 个月入组。采用差值法（DID）比较普瑞巴林和加巴喷丁治疗患者在索引前至索引后 12 个月全因和 pDPN 相关资源利用和成本的变化。
共纳入 910 例普瑞巴林患者（48.6%为女性；平均年龄 63.3±12.1 岁）和 910 例加巴喷丁患者（48.8%为女性；平均年龄 63.3±12.1 岁）。DID 显示，在全因资源利用类别中，各队列在索引前至索引后变化方面均无显著差异。尽管普瑞巴林的处方费用显著增加（DID-563 美元；p<0.0001），但每位患者的总医疗费用 DID 为 1603 美元，表明普瑞巴林和加巴喷丁患者的索引前至索引后增加额相当，分别为 3081 美元和 4684 美元（p=0.8474）。由于处方费用较高（DID-432 美元；p<0.0001），普瑞巴林的全因 pDPN 相关医疗费用显著更高（DID-385 美元；p<0.0001）。
在开始使用普瑞巴林或加巴喷丁的患者中，尽管普瑞巴林的处方费用增加，但药物在全因总医疗费用方面，索引前至索引后变化无显著差异。
