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Descriptive analysis of Medicaid patients with postherpetic neuralgia treated with lidocaine patch 5%.

Abstract：

OBJECTIVES:To compare demographic and comorbidity profiles and healthcare costs of Medicaid patients with postherpetic neuralgia (PHN) treated with lidocaine patch 5% (lidocaine patch) versus patients not treated with the lidocaine patch. Repeat comparison for the subset of patients treated in long-term care (LTC) settings. METHODS:Patients, age≥18 years, with PHN diagnosis, or PHN-likely patients with herpes zoster diagnosis and ≥30 days of PHN-recommended treatment, were identified in Medicaid claims from Florida, Iowa, Missouri, and New Jersey (1999-2007). Patients had continuous eligibility 6 months before (baseline) and 12 months after (study period) the PHN index date. Patients with ≥1 claim for a lidocaine patch during the study period (n=872) were compared to patients without a lidocaine patch claim (comparison group). Baseline characteristics, study period treatment and healthcare costs (reimbursements by Medicaid for medical services and prescription drugs) were compared between groups using univariate analyses. RESULTS:PHN patients in the lidocaine patch group were older (64.5 vs. 62.2 years; p=0.002) and had higher rates of pain-related comorbidities (e.g., back/neck pain, osteoarthritis) than comparison patients. Average PHN-related drug costs per patient were higher ($1994 vs. 1137; p<0.0001) among lidocaine patch patients, with lidocaine patch accounting for $505 of the difference. PHN-related medical costs appeared lower in the lidocaine patch group, although not statistically significant ($983 vs. 1294; p=0.1348). No significant differences were found in total healthcare costs ($20,175 vs. 19,124; p=0.3720) across groups, despite higher total prescription drug costs among lidocaine patch patients. A similar pattern was observed among LTC patients. CONCLUSIONS:Despite higher rates of comorbidities and prescription drug costs, lidocaine patch patients had similar study period healthcare costs as comparison patients. The cost of the lidocaine patch represented a small fraction of overall costs incurred over the study period. LIMITATIONS:Findings are based on a Medicaid sample and may not be generalizable to all PHN patients.

journal_name

J Med Econ

journal_title

Journal of medical economics

authors

Kirson NY,Ivanova JI,Birnbaum HG,Wei R,Kantor E,Amy Puenpatom R,Ben-Joseph RH,Summers KH

doi

10.3111/13696998.2010.499819

subject

Has Abstract

pub_date

2010-01-01 00:00:00

pages

472-81

issue

eissn

1369-6998

issn

1941-837X

journal_volume

pub_type

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Descriptive analysis of Medicaid patients with postherpetic neuralgia treated with lidocaine patch 5%.