Decreased Opioid Utilization with Lidocaine Topical System 1.8% Compared to Lidocaine 5% Patch: A retrospective Claims Analysis

Abstract

Aim/Design

Using retrospective claims data from Optum's de-identified Normative Health Informatics database (5/2018 to 9/2023), we evaluated the impact of different lidocaine topical systems on the utilization of opioids in patients with neuropathic pain (post-herpetic neuralgia, diabetic peripheral neuropathy or lower back pain).

Results

The final analysis included 6,014 patients taking opioids and either lidocaine topical system 1.8% or lidocaine patch 5% as index treatment. 51.9% of lidocaine topical system patients experienced either a decrease or discontinuation of opioid use in the post-prescription period compared to 45.5% of lidocaine patch patients (Chi-square test, p=0.021). Lidocaine topical system patients had a non-significant change in pre- versus post-prescription median Morphine Milligram Equivalents (MME) (3.1% increase, Wilcoxon signed rank test, p=0.146); while lidocaine patch patients experienced a significant increase in pre-versus post-prescription median MME (42.9% increase, Wilcoxon signed rank test, p<0.001). Based on these data, lidocaine topical system usage may be associated with reduced opioid utilization compared with lidocaine patch.

Nursing Implications

Nurses are at the forefront of patient care and play an important role in helping patients to reduce opioid utilization. Thus, it is crucial for them to have the most up-to-date information on non-opioid treatment options that may optimize pain management and reduce unnecessary opioid usage.

Implications for future research

Further analysis of the data is needed to understand the patient subpopulations that are most impacted.