Presented at the 2012 AAPM Annual Meeting « Back

Retrospective Analyses of Gabapentin and Pregabalin Use in Patients with Postherpetic Neuralgia (PHN)

Phaedra T. Johnson, MS, phaedra.johnson@innovus.com¹, Rachel Halpern, PhD¹, Laura Baker, MA¹, Michael Sweeney, MD², (1) OptumInsight, Eden Prairie, Minnesota, (2) Depomed Inc., Menlo Park, California

Introduction: Gabapentin and pregabalin are first-line treatments for postherpetic neuralgia (PHN). Both therapies are administered 2–4 times per day and require titration to an effective dose over several weeks. Materials and Methods: Mean daily dose, duration of therapy, number of fills, and time to reach maximal dose were examined using claims data from a large U.S. health plan. Commercial and Medicare Advantage enrollees with PHN initiating treatment with gabapentin or pregabalin from July 2006 to February 2009 with 6 months of data preceding and 12 months following the index date (first pharmacy claim) were included. Results: 1,645 patients (gabapentin, 939; pregabalin, 706) were identified. The mean daily doses during follow-up were 826 mg (gabapentin) and 187 mg (pregabalin); the mean number of days on therapy over follow-up was 73 days (gabapentin) and 80 days (pregabalin). The mean maximum dose of was 970 mg (gabapentin) and 222 mg (pregabalin); average time to reach maximum dose was 30 days for each. Only 14.3% of patients reached ≥1800 mg of gabapentin; 86.5% of patients reached ≥150 mg of pregabalin. The average number of fills was 3.1 (gabapentin) and 3.3 (pregabalin); 52.6% (gabapentin) and 57.0% (pregabalin) of patients obtained a single fill. Conclusions: In a real-world setting, few patients with PHN reached an effective dose of gabapentin. Although better success was seen with pregabalin, the average time to reach maximal dose and average number of refills was comparable to gabapentin.

Funding: None