Medication utilization before and after initiation of pregabalin treatment in patients enrolled in a commercial health plan

Abstract

Fibromyalgia is the most common chronic, widespread pain condition in the United States. Fibromyalgia results in high levels of medication and health care service utilization and cost. The objective of this retrospective case-control study was to assess medication utilization of patients enrolled in a commercial health plan before and after pregabalin therapy. Each patient served as their own control pre and post initiation of pregabalin. Patient population was between the ages of 18 and 85, was enrolled in a commercial health plan and had a persistent 12 months of pregabalin therapy. Data collected included age, gender, number of total medications, medications by therapeutic category, emergency room visits, office visits, and total services. Out of 1677 patients filling a prescription for pregabalin there were a total of 363 patients with 12 month persistence. (Persistence rate of 22%) The mean age was 50 years and 70% were female. The average number of medications per patient decreased by 13% after 12 months of pregabalin, compared to 12 months prior to therapy. Prior to pregabalin the top four prescription medications in descending order were hydrocodone, gabapentin, zolpidem and duloxetine. Post pregabalin the top four prescription medications in order were, pregabalin, hydrocodone, duloxetine and celocoxib. Medications were further analyzed according to therapeutic categories. After 12 months of persistent pregabalin utilization, medications specific for treatment of fibromyalgia increased by 47%. Sleep medications increased by 20%, pain medications increased by 21%, long acting opiates decreased by 19%, and anti-depressants increased by 17%. There were no significant changes in emergency room visits, but office visits decreased by 19% over the 12 month pregabalin treatment period. This analysis was of fibromyalgia patients with probable multiple co-morbid conditions over a 2.5 year time frame. Fibromyalgia is the most common chronic, widespread pain condition in the United States. Fibromyalgia results in high levels of medication and health care service utilization and cost. The objective of this retrospective case-control study was to assess medication utilization of patients enrolled in a commercial health plan before and after pregabalin therapy. Each patient served as their own control pre and post initiation of pregabalin. Patient population was between the ages of 18 and 85, was enrolled in a commercial health plan and had a persistent 12 months of pregabalin therapy. Data collected included age, gender, number of total medications, medications by therapeutic category, emergency room visits, office visits, and total services. Out of 1677 patients filling a prescription for pregabalin there were a total of 363 patients with 12 month persistence. (Persistence rate of 22%) The mean age was 50 years and 70% were female. The average number of medications per patient decreased by 13% after 12 months of pregabalin, compared to 12 months prior to therapy. Prior to pregabalin the top four prescription medications in descending order were hydrocodone, gabapentin, zolpidem and duloxetine. Post pregabalin the top four prescription medications in order were, pregabalin, hydrocodone, duloxetine and celocoxib. Medications were further analyzed according to therapeutic categories. After 12 months of persistent pregabalin utilization, medications specific for treatment of fibromyalgia increased by 47%. Sleep medications increased by 20%, pain medications increased by 21%, long acting opiates decreased by 19%, and anti-depressants increased by 17%. There were no significant changes in emergency room visits, but office visits decreased by 19% over the 12 month pregabalin treatment period. This analysis was of fibromyalgia patients with probable multiple co-morbid conditions over a 2.5 year time frame.