Prior Authorization in the Treatment of Patients with pDPN and FM. Issue 1 (11th November 2014)

• Record Type: Journal Article
• Authors: Placzek, Hilary E. D.; Masters, Elizabeth T.; Gu, Tao; Cappelleri, Joseph C.; Wasser, Thomas E.; Clair, Andrew G.; Cook, Joseph P.; Eisenberg, Debra F.
• Is Part Of: Pain practice. Volume 15:Issue 1(2015)
• Page Start: E9
• Page End: E19
• Publication Date: 2014-11-11
• Subjects: Pain -- Treatment -- Periodicals; 616.0472
• DOI: 10.1111/papr.12258
• Languages: English
• ISSNs: 1530-7085

Abstract

<abstract abstract-type="main" id="papr12258-abs-0001"> <title>Abstract</title> <sec id="papr12258-sec-0001" sec-type="section"> <title>Purpose</title> <p>To determine prior authorization (PA) impact on healthcare utilization, costs, and pharmacologic treatment patterns for painful diabetic peripheral neuropathy (pDPN) and fibromyalgia (FM).</p> </sec> <sec id="papr12258-sec-0002" sec-type="section"> <title>Methods</title> <p>This retrospective, observational, longitudinal cohort study used medical and pharmacy claims data. Newly diagnosed patients treated for FM or pDPN between 7/1/2007 and 12/31/2011 were included. PA and no PA groups were matched by propensity score 4:1. Medical resource utilization, direct medical and pharmacy costs, and treatment pattern differences were compared. Pre and postindex differences between PA and no PA cohorts were determined by difference in difference analysis.</p> </sec> <sec id="papr12258-sec-0003" sec-type="section"> <title>Results</title> <p>Analysis of 2, 315 FM patients (1, 852 PA; 463 no PA) demonstrated greater increases in postindex all‐cause costs ($197; <italic>P</italic> = 0.6673) and disease‐related costs ($72; <italic>P</italic> = 0.4186) in the PA cohort. Analysis of 1, 300 pDPN patients (1, 040 PA; 260 no PA) demonstrated postindex all‐cause cost increases of $1, 155 more in the no PA cohort (<italic>P</italic> = 0.6248); disease‐related costs decreased $2, 809 more in the no PA cohort (<italic>P</italic> = 0.4312). Treatment patterns were similar between cohorts; opioid usage was higher in the FM PA cohort (<italic>P</italic> = 0.0082).</p> </sec> <sec id="papr12258-sec-0004" sec-type="section"> <title>Conclusions</title> <p>There was no evidence of statistically significant differences between PA and no PA cohorts in either FM or pDPN populations for total all‐cause or disease‐related costs.</p> </sec> </abstract>