Smith Amelia, Doran Stephen, Daly Maria, Kennedy Cormac, Barry Michael
Department of Pharmacology and Therapeutics, Trinity College Dublin, Trinity Centre for Health Sciences, St. James' Hospital, Dublin 8, Ireland.
Medicines Management Programme, Health Service Executive, St. James' Hospital, Dublin 8, Ireland.
Appl Health Econ Health Policy. 2021 Jan;19(1):133-140. doi: 10.1007/s40258-020-00586-5.
The lidocaine 5% medicated plaster, Versatis, has one therapeutic indication listed on the Summary of Product Characteristics-symptomatic relief of post-herpetic neuralgia (PHN) in adults. Increased expenditure on Versatis suggests that there is considerable off-label use. To support the appropriate use of Versatis, the Health Service Executive's Primary Care Reimbursement Service (PCRS) introduced a reimbursement application system for Versatis from 1 September 2017.
The aim of this study was to investigate the effect of introducing a reimbursement application system on Versatis prescribing under the General Medical Services (GMS) scheme.
This study was carried out using prescription dispensing data from the PCRS pharmacy claims database. We carried out segmented linear regression to assess changes in the Versatis prescribing rate per 1000 GMS eligible population, before and after the introduction of the online reimbursement application system.
The results of the segmented regression analysis show that there was a statistically significant level (- 4.91, p < 0.001) and trend change (- 0.69, p < 0.001) in the rate of Versatis prescribing post-introduction of the reimbursement application system. In the year prior to the introduction of the system, 2016, the annual GMS expenditure on Versatis lidocaine 5% patches was over €27 million, whereas the GMS expenditure in 2018 was reduced to just over €2 million.
In our study, a substantial decrease in the dispensing of Versatis was seen after the implementation of a reimbursement application system. Prescribing of Versatis should be restricted to patients with a diagnosis of PHN not only to reduce costs, but to ensure evidence-based use of this medication.
5%利多卡因药用贴剂（Versatis）在其产品特性摘要中列出了一项治疗适应症——缓解成人疱疹后神经痛（PHN）的症状。Versatis支出的增加表明存在大量的超适应症使用情况。为支持Versatis的合理使用，卫生服务执行局的初级医疗报销服务（PCRS）从2017年9月1日起引入了Versatis报销申请系统。
本研究的目的是调查引入报销申请系统对一般医疗服务（GMS）计划下Versatis处方开具的影响。
本研究使用了PCRS药房报销数据库中的处方配药数据。我们进行了分段线性回归，以评估在线报销申请系统引入前后每1000名符合GMS资格人群中Versatis处方开具率的变化。
分段回归分析结果显示，报销申请系统引入后，Versatis处方开具率存在统计学显著水平（-4.91，p<0.001）和趋势变化（-0.69，p<0.001）。在该系统引入前的2016年，GMS每年在5%利多卡因Versatis贴剂上的支出超过2700万欧元，而2018年GMS的支出降至略高于200万欧元。
在我们的研究中，实施报销申请系统后，Versatis的配药量大幅下降。Versatis的处方应仅限于诊断为PHN的患者，这不仅是为了降低成本，也是为了确保该药物的循证使用。
