Impact of a step-therapy protocol for pregabalin on healthcare utilization and expenditures in a commercial population

Journal of Medical Economics

Volumn 16, Issue 6, 2013, Pages 784-792

  Udall, Margarita ^a   Louder, Anthony ^b   Suehs, Brandon T ^b   Cappelleri, Joseph C ^a   Joshi, Ashish V ^a   Patel, Nick C ^b  

^a PFIZER INC   (United States)

^b Research Scientist   (United States)

Author keywords

Costs; Diabetic peripheral neuropathy; Fibromyalgia; Postherpetic neuralgia; Pregabalin; Step therapy

Indexed keywords

PREGABALIN;

ADULT; AGED; ARTICLE; CLINICAL PROTOCOL; COHORT ANALYSIS; CONTROLLED STUDY; FEMALE; FOLLOW UP; HEALTH CARE COST; HEALTH CARE UTILIZATION; HEALTH IMPACT ASSESSMENT; HUMAN; MAJOR CLINICAL STUDY; MALE; OBSERVATIONAL STUDY; PARALLEL DESIGN; PHYSIOTHERAPY; RETROSPECTIVE STUDY;

ADOLESCENT; ADULT; AGED; ANALGESICS; COST CONTROL; DATABASES, FACTUAL; DIABETIC NEUROPATHIES; FEMALE; FIBROMYALGIA; GAMMA-AMINOBUTYRIC ACID; GATEKEEPING; HEALTH EXPENDITURES; HUMANS; INSURANCE, PHARMACEUTICAL SERVICES; MALE; MIDDLE AGED; NEURALGIA, POSTHERPETIC; PHARMACEUTICAL SERVICES; RETROSPECTIVE STUDIES; YOUNG ADULT;

EID: 84878909090     PISSN: 13696998     EISSN: 1941837X     Source Type: Journal    
DOI: 10.3111/13696998.2013.793692     Document Type: Article

References (24)

1. Pharmacy Benefit Management Institute. 2011-2012 Prescription Drug Benefit Cost and Plan Design Report. [online]. Plano, TX: Pharmacy Benefit Management Institute, LP, 2011. http://www.benefitdesignreport.com/. Accessed August 6, 2012
2. Yokoyama K, Yang W, Preblick R, et al. Effects of a step-therapy program for angiotensin receptor blockers on antihypertensive medication utilization patterns and cost of drug therapy. J Manag Care Pharm 2007;13: 235-44
3. Dunn JD, Cannon E, Mitchell MP, et al. Utilization and drug cost outcomes of a step-therapy edit for generic antidepressants in an HMO in an integrated health system. J Manag Care Pharm 2006;12:294-302
4. Lu CY, Law MR, Soumerai SB, et al. Impact of prior authorization on the use and costs of lipid-lowering medications among Michigan and Indiana dual enrollees in Medicaid and Medicare: results of a longitudinal, populationbased study. Clin Ther 2011;33:135-44
5. Law MR, Lu CY, Soumerai SB, et al. Impact of two Medicaid prior-authorization policies on antihypertensive use and costs among Michigan and Indiana residents dually enrolled in Medicaid and Medicare: results of a longitudinal, population-based study. Clin Ther 2010;32:729-41
6. Motheral BR, Henderson R, Cox ER. Plan-sponsor savings and member experience with point-of-service prescription step therapy. Am J Manag Care 2004;10:457-564
7. Margolis JM, Johnston SS, Chu BC, et al. Effects of a Medicaid prior authorization policy for pregabalin. Am J Manag Care 2009;15:e95-102
8. Margolis JM, Cao Z, Onukwugha E, et al. Healthcare utilization and cost effects of prior authorization for pregabalin in commercial health plans. Am J Manag Care 2010;16:447-56
9. Mark TL, Gibson TB, McGuigan KA. The effects of antihypertensive steptherapy protocols on pharmaceutical and medical utilization and expenditures. Am J Manag Care 2009;15:123-31
10. Mark TL, Gibson TM, McGuigan K, et al. The effects of antidepressant step therapy protocols on pharmaceutical and medical utilization and expenditures. Am J Psychiatry 2010;167:1202-9
11. Lyrica-[pregabalin] capsules prescribing information. New York, NY: Pfizer, Inc., 2012
12. Neurontin-[gabapentin] prescribing information. New York, NY: Pfizer, Inc., 2011
13. Arnold LM, Goldenberg D, Stanford SB, et al. Gabapentin in the treatment of fibromyalgia. A randomized, double-blind, placebo-controlled, multicenter trial. Arthritis Rheum 2007;56:1336-44
14. Backonja M, Beydoun A, Edwards KR, et al. Gabapentin for the symptomatic treatment of painful neuropathy in patients with diabetes mellitus: a randomized controlled trial. JAMA 1998;280:1831-6
15. Fishman PA, Goodman MJ, Hornbrook MC, et al. Risk adjustment using automated ambulatory pharmacy data: the RxRisk model. Med Care 2003;41:84-99
16. Sloan KL, Sales AE, Liu CF, et al. Construction and characteristics of the RxRisk-V: a VA-adapted pharmacy-based case-mix instrument. Med Care 2003;41:761-74
17. Sales AE, Liu CF, Sloan KL, et al. Predicting costs of care using a pharmacybased measure risk adjustment in a veteran population. Med Care 2003;41:753-60
18. Kleinbaum DG, Klein M. Logistic Regression. A Self-Learning Text. 3rd ed. New York, NY: Springer-Verlag, 2010
19. Littell RC, Milliken GA, Stroup WW, et al. SAS-for Mixed Models. 2nd ed. Cary, NC: SAS Institute Inc., 2006
20. Vonesh EF. Generalized linear and nonlinear models for correlated data: theory and applications using SAS. Cary, NC: SAS Institute Inc., 2012
21. Motheral BR. Pharmaceutical step-therapy interventions: a critical review of the literature. J Manag Care Pharm 2011;17:143-55
22. Mackinnon NJ, Kumar R. Prior authorization programs: a critical review of the literature. J Manag Care Pharm 2001;7:297-302
23. Shoemaker SJ, Pozniak A, Subramanian R, et al. Effect of 6 managed care pharmacy tools: a review of the literature. J Manag Care Pharm 2010;16:S3-20
24. Duan N. Smearing estimate: a nonparametric retransformation method. J Am Stat Assoc 1983;78:605-10