Changes in Pregabalin Dispensing to Australians with Workers' Compensation Claims for Low Back Pain Following the Listing of Pregabalin on the Pharmaceutical Benefits Scheme.
Michael F Di Donato, Christina Abdel Shaheed, Alex Collie, Christopher G Maher, Stephanie Mathieson
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引用次数: 0
Abstract
Objectives: We sought to identify whether the inclusion of pregabalin on the list of medicines subsidised by the Australian government in 2013 resulted in changes to the dispensing of pregabalin to Australians with workers' compensation claims for low back pain.
Methods: Using a sample of workers' compensation claims and payments data (2010-2018), we measured the prevalence of pregabalin dispensing and time to first pregabalin dispensing in workers whose claim began before, during or after pregabalin was listed on the Pharmaceutical Benefits Scheme (PBS) with binary logistic and Cox proportional hazards models. We used interrupted time-series analyses to measure changes in the monthly number, percentage of pain medicines, percentage of gabapentinoid dispensings, and median cost per dispensing of pregabalin.
Results: Of the 17,689 workers included in the study, 13.7% (n = 2431) were dispensed pregabalin during the study period. Workers in the groups whose claim occurred before or during when pregabalin was listed on the PBS were at significantly lower odds of being dispensed pregabalin than the group whose claim began after PBS listing (OR 0.20, 99% CI 0.15, 0.25 and OR 0.40, 99% CI 0.33, 0.48, respectively). There were significant step increases in the number of pregabalin dispensings (26.3%, 99% CI 6.2%, 50.3%), percentage of pain medicines that were pregabalin (29.3%, 99% CI 1.5%, 64.9%), and percentage of gabapentinoid dispensings that were pregabalin (13.9%, 99% CI 7.5%, 20.6%). There was a significant step decrease in the median cost per pregabalin dispensing (- 61.8%, 99% CI - 66.8%, - 56.1%).
Conclusion: Listing pregabalin on the PBS saw significant increases in the prevalence, number and percentage of pain medicines, and significant decreases in time to first pregabalin dispensing and cost.
目的:我们试图确定2013年将普瑞巴林纳入澳大利亚政府补贴的药物清单是否会导致普瑞巴林分配给患有腰痛工人赔偿索赔的澳大利亚人的变化。方法:利用2010-2018年工人赔偿索赔和支付数据样本,采用二元logistic和Cox比例风险模型,测量在普瑞巴林被列入药品福利计划(PBS)之前、期间和之后开始索赔的工人普瑞巴林的配发率和首次配发普瑞巴林的时间。我们使用中断时间序列分析来测量每月数量的变化、止痛药的百分比、加巴喷丁类药物的百分比和普瑞巴林每次分配的中位数成本。结果:在纳入研究的17,689名工人中,13.7% (n = 2431)在研究期间使用了普瑞巴林。在PBS列出普瑞巴林之前或期间索赔的工人比在PBS列出之后索赔的工人分配普瑞巴林的几率显着降低(分别为or 0.20, 99% CI 0.15, 0.25和or 0.40, 99% CI 0.33, 0.48)。普瑞巴林配剂数量(26.3%,99% CI 6.2%, 50.3%)、普瑞巴林止痛药百分比(29.3%,99% CI 1.5%, 64.9%)和加巴喷丁类配剂百分比(13.9%,99% CI 7.5%, 20.6%)均显著增加。每个普瑞巴林分配的中位成本显著下降(- 61.8%,99% CI - 66.8%, - 56.1%)。结论:将普瑞巴林列入PBS后,疼痛药物的患病率、数量和百分比显著增加,首次配药普瑞巴林的时间和费用显著减少。
期刊介绍:
The Journal of Occupational Rehabilitation is an international forum for the publication of peer-reviewed original papers on the rehabilitation, reintegration, and prevention of disability in workers. The journal offers investigations involving original data collection and research synthesis (i.e., scoping reviews, systematic reviews, and meta-analyses). Papers derive from a broad array of fields including rehabilitation medicine, physical and occupational therapy, health psychology and psychiatry, orthopedics, oncology, occupational and insurance medicine, neurology, social work, ergonomics, biomedical engineering, health economics, rehabilitation engineering, business administration and management, and law. A single interdisciplinary source for information on work disability rehabilitation, the Journal of Occupational Rehabilitation helps to advance the scientific understanding, management, and prevention of work disability.