Document Detail

Evaluation of healthcare resource utilization and costs in employees with pain associated with diabetic peripheral neuropathy treated with pregabalin or duloxetine.
MedLine Citation:
PMID:  21091395     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To evaluate changes in healthcare resource use and costs after initiating pregabalin or duloxetine in employees with pain associated with diabetic peripheral neuropathy (pDPN).
METHODS: Employees (18-64 years old) with a DPN diagnosis and at least one pDPN-related pain medication claim were identified using the MarketScan Commercial Database (2005-2008). Propensity scored matched pregabalin and duloxetine new starts were evaluated in the 6-month pre- and 6-month post-initiation periods. Study outcomes including imputed medically-related work loss, prescription and healthcare utilization, and associated expenditures were analyzed using univariate statistics and multivariate models in a difference-in-difference approach.
RESULTS: A total of 473 employees in each treatment group were identified. Mean age was 53.6 (SD 7.0) years for pregabalin and 53.5 (SD 7.4) years for duloxetine. There were no pre-index differences between groups. Adjusted marginal effects were not statistically significant for pre-to-post changes in opioid utilization (p = 0.328), number of pDPN-related analgesic medications (p = 0.506), all-cause healthcare costs (p = 0.895), indirect costs (p = 0.324), or pDPN-attributable expenditures (p = 0.359).
LIMITATIONS: Claims analysis is limited in accounting for all patient and plan differences, and by the reliability of medical claims for diagnosis coding. The sample size of the matched cohorts may have limited the power of the analysis to detect differences.
CONCLUSIONS: There were no significant pre-to-post differences between pregabalin and duloxetine treatment groups in pDPN-related analgesic medication use, or pDPN-attributable, all-cause, and indirect expenditures.
Jay Margolis; Zhun Cao; Robert Fowler; James Harnett; Robert J Sanchez; Jack Mardekian; Stuart L Silverman
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-11-24
Journal Detail:
Title:  Journal of medical economics     Volume:  13     ISSN:  1941-837X     ISO Abbreviation:  J Med Econ     Publication Date:  2010  
Date Detail:
Created Date:  2010-12-08     Completed Date:  2011-05-03     Revised Date:  2013-08-21    
Medline Journal Info:
Nlm Unique ID:  9892255     Medline TA:  J Med Econ     Country:  England    
Other Details:
Languages:  eng     Pagination:  738-47     Citation Subset:  IM    
Thomson Reuters, Healthcare & Science, Washington, DC 19004, USA.
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MeSH Terms
Age Factors
Analgesics / economics*,  therapeutic use
Diabetic Neuropathies / complications
Health Services / economics,  utilization*
Insurance Claim Review
Middle Aged
Pain / drug therapy*,  etiology
Sex Factors
Socioeconomic Factors
Thiophenes / economics*,  therapeutic use
Young Adult
gamma-Aminobutyric Acid / analogs & derivatives*,  economics,  therapeutic use
Reg. No./Substance:
0/Analgesics; 0/Thiophenes; 55JG375S6M/pregabalin; 56-12-2/gamma-Aminobutyric Acid; O5TNM5N07U/duloxetine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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