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

Author(s): Kirson NY, Ivanova JI, Birnbaum HG, Wei R, Kantor E, Amy Puenpatom R, Ben-Joseph RH, Summers KH

Affiliation(s): Analysis Group, Inc., Boston, MA 02199, USA. nkirson@analysisgroup.com

Publication date & source: 2010, J Med Econ., 13(3):472-81.

Publication type: Research Support, Non-U.S. Gov't

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.

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