Pain-related pharmacotherapy, healthcare resource use and costs in spinal cord injury patients prescribed pregabalin

Abstract

Retrospective database analysis. To describe comorbidities, pain-related pharmacotherapy, healthcare resource use and costs among patients with spinal cord injury (SCI) newly prescribed pregabalin. United Kingdom (UK). Using The Health Improvement Network database, SCI patients newly prescribed (index event) pregabalin (N=72; average age 48 years; 53% female) were selected. Study measures were evaluated during both the 9-months pre-index and follow-up periods. Prevalent comorbidities included musculoskeletal disorders (51.4%), digestive disorders (23.6%) and urogenital disorders (20.8%). Opioids were the most frequently prescribed medications (pre-index, 58.3%; follow-up, 61.1%, P=not significant (NS)) followed by nonsteroidal anti-inflammatory drugs (43.1 and 45.8%, P=NS). Use of anti-epileptics (other than pregabalin) recommended for SCI neuropathic pain decreased (25.0 vs 12.5%, P=0.0290), whereas sedative/hypnotic use (18.1 vs 26.4%, P=0.034) increased during follow-up. Over 50% of patients had visits to specialists, and at least 1 in every 10 had laboratory/radiology-related visits. There were numerical decreases in proportions of patients with emergency room visits (22.2 vs 13.9%, P=NS) and hospitalizations (16.7 vs 12.5%, P=NS) during follow-up. Medication costs were higher during follow-up (median, £ 561.4 vs £ 889.5, P<0.0001). Costs of outpatient visits were similar during both study periods (£ 1082.1 vs £ 1066.1) as were total medical costs (£ 1689.0 vs £ 2169.4) when costs of pregabalin prescriptions were excluded. Inclusion of pregabalin costs resulted in higher (P<0.0001) total medical costs during follow-up. SCI patients had a high comorbidity, medication and healthcare resource use burden in clinical practice. Further research with larger sample sizes and more comprehensive data sources may serve to clarify study findings.