Opioid Utilization and Health‐Care Costs among Patients with Diabetic Peripheral Neuropathic Pain Treated with Duloxetine vs. Other Therapies

Wu, Ning; Chen, Shih‐Yin; Hallett, Lindsay A.; Boulanger, Luke; Fraser, K; Patel, Chintan K.; Zhao, Yang

doi:10.1111/j.1533-2500.2010.00392.x

Cited by 16 publications

(10 citation statements)

References 28 publications

(57 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 28 – 30 Chen et al and Wu et al performed very similar historical cohort analyses among patients starting treatment for DPNP with either DUL or SOC in patients not currently receiving opioids. 28 , 29 A significantly lower proportion of DUL patients had opioid use than SOC medications after starting DPNP treatment was reported by Chen et al (DUL 52.1% vs SOC 84.6%, P <0.05), and Wu et al (DUL 54.0% vs SOC 76.7%, P <0.05). Wu et al also found DUL to be associated with significantly lower adjusted odds of opioid use when compared to SOC (odds ratio 0.38, P <0.05).…”

Section: Real-world Studiesmentioning

confidence: 81%

A review of the clinical utility of duloxetine in the treatment of diabetic peripheral neuropathic pain

King¹,

Schauerhamer²,

Bellows³

2015

TCRM

View full text Add to dashboard Cite

Diabetes mellitus is a world-wide epidemic with many long-term complications, with neuropathy being the most common. In particular, diabetic peripheral neuropathic pain (DPNP), can be one of the most distressing complications associated with diabetes, leading to decreases in physical and mental quality of life. Despite the availability of many efficient medications, DPNP remains a challenge to treat, and the optimal sequencing of pharmacotherapy remains unknown. Currently, there are only three medications approved by the US Food and Drug Administration specifically for the management of DPNP. Duloxetine (DUL), a selective serotonin-norepinephrine reuptake inhibitor, is one of these. With the goal of optimizing pharmacotherapy use in DPNP population, a review of current literature was conducted, and the clinical utility of DUL described. Along with early clinical trials, recently published observational studies and pharmacoeconomic models may be useful in guiding decision making by clinicians and managed care organizations. In real-world practice settings, DUL is associated with decreased or similar opioid utilization, increased medication adherence, and similar health care costs compared with current standard of care. DUL has consistently been found to be a cost-effective option over short time-horizons. Currently, the long-term cost-effectiveness of DUL is unknown. Evidence derived from randomized clinical trials, real-world observations, and economic models support the use of DUL as a first-line treatment option from the perspective of the patient, clinician, and managed care payer.

show abstract

Section: Real-world Studiesmentioning

confidence: 81%

A review of the clinical utility of duloxetine in the treatment of diabetic peripheral neuropathic pain

King¹,

Schauerhamer²,

Bellows³

2015

TCRM

View full text Add to dashboard Cite

show abstract

“…Previous retrospective studies across various patient populations and utilizing disparate definitions of opioid utilization have incongruent findings regarding the opioid-sparing effect of pregabalin 31 , 40 , 41 and duloxetine. 31 , 42 In the lone head-to-head retrospective analysis of these drugs in a FM population, no changes in pre- to postinitiation of long-acting, short-acting, strong opioid, weak opioid, or any opioid use were found for pregabalin. 31 These findings held for duloxetine with the exception of a decrease in weak opioid use from pre- to postinitiation periods (55.1% vs 49.3%, respectively; P =0.0027), as defined by the percentage of patients with one or more pharmacy claims for those categories of opioids.…”

Section: Discussionmentioning

confidence: 99%

Impact of potential pregabalin or duloxetine drug–drug interactions on health care costs and utilization among Medicare members with fibromyalgia

Ellis¹,

Sadosky²,

Eyck³

et al. 2014

CEOR

View full text Add to dashboard Cite

PurposeTo examine the impact of newly initiated pregabalin or duloxetine treatment on fibromyalgia (FM) patients’ encounters with potential drug–drug interactions (DDIs), the health care cost and utilization consequences of those interactions, and the impact of treatment on opioid utilization.Patients and methodsSubjects included those with an FM diagnosis, a pregabalin or duloxetine prescription claim (index event), ≥1 inpatient or ≥2 outpatient medical claims, and ≥12 months preindex and ≥6 postindex enrollment. Propensity score matching was used to help balance the pregabalin and duloxetine cohorts on baseline demographics and comorbidities. Potential DDIs were defined based on Micromedex 2.0 software and were identified by prescription claims.ResultsNo significant differences in baseline characteristics were found between matched pregabalin (n=794) and duloxetine cohorts (n=794). Potential DDI prevalence was significantly greater (P<0.0001) among duloxetine subjects (71.9%) than among pregabalin subjects (4.0%). There were no significant differences in all-cause health care utilization or costs between pregabalin subjects with and without a potential DDI. By contrast, duloxetine subjects with a potential DDI had higher mean all-cause costs ($9,373 versus $7,228; P<0.0001) and higher mean number of outpatient visits/member (16.0 versus 13.0; P=0.0009) in comparison to duloxetine subjects without a potential DDI. There was a trend toward a statistically significant difference between pregabalin and duloxetine subjects in their respective pre- versus post-differences in use of ≥1 long-acting opioids (1.6% and 3.4%, respectively; P=0.077).ConclusionThe significantly higher prevalence of potential DDIs and potential cost impact found in FM duloxetine subjects, relative to pregabalin subjects, underscore the importance of considering DDIs when selecting a treatment.

show abstract

“…For example, SNRIs have been shown to reduce opioid usage [24]. For highrisk patients, methadone is the preferred opioid, because it provides good analgesia while reducing the risk for diversion and abuse.…”

Section: Addiction and Diversionmentioning

confidence: 99%

Pain Management

Liao¹,

Skavinski²,

Capasso³

et al. 2015

Hospital‐Based Palliative Medicine

View full text Add to dashboard Cite

Opioid Utilization and Health‐Care Costs among Patients with Diabetic Peripheral Neuropathic Pain Treated with Duloxetine vs. Other Therapies

Abstract: DPNP patients who initiated duloxetine therapy were less likely to have subsequent opioid use and had lower health-care costs than SOC patients.

Cited by 16 publications

References 28 publications

A review of the clinical utility of duloxetine in the treatment of diabetic peripheral neuropathic pain

A review of the clinical utility of duloxetine in the treatment of diabetic peripheral neuropathic pain

Impact of potential pregabalin or duloxetine drug–drug interactions on health care costs and utilization among Medicare members with fibromyalgia

Pain Management

Contact Info

Product

Resources

About

Opioid Utilization and Health‐Care Costs among Patients with Diabetic Peripheral Neuropathic Pain Treated with Duloxetine vs. Other Therapies

Abstract: DPNP patients who initiated duloxetine therapy were less likely to have subsequent opioid use and had lower health-care costs than SOC patients.

Cited by 16 publications

References 28 publications

A review of the clinical utility of duloxetine in the treatment of diabetic peripheral neuropathic pain

A review of the clinical utility of duloxetine in the treatment of diabetic peripheral neuropathic pain

Impact of potential pregabalin or duloxetine drug&ndash;drug interactions on health care costs and utilization among Medicare members with fibromyalgia

Pain Management

Contact Info

Product

Resources

About

Impact of potential pregabalin or duloxetine drug–drug interactions on health care costs and utilization among Medicare members with fibromyalgia