Prescribing practice of pregabalin/gabapentin in pain therapy: an evaluation of German claim data.

Abstract

OBJECTIVES:

To analyse the prevalence and incidence of pregabalin and gabapentin (P/G) prescriptions, typical therapeutic uses of P/G with special attention to pain-related diagnoses and discontinuation rates.

DESIGN:

Secondary data analysis.

SETTING:

Primary and secondary care in Germany.

PARTICIPANTS:

Four million patients in the years 2009-2015 (anonymous health insurance data).

INTERVENTION:

None.

PRIMARY AND SECONDARY OUTCOME MEASURES:

P/G prescribing rates, P/G prescribing rates associated with pain therapy, analysis of pain-related diagnoses leading to new P/G prescriptions and the discontinuation rate of P/G.

RESULTS:

In 2015, 1.6% of insured persons received P/G prescriptions. Among the patients with pain first treated with P/G, as few as 25.7% were diagnosed with a typical neuropathic pain disorder. The remaining 74.3% had either not received a diagnosis of neuropathic pain or showed a neuropathic component that was pathophysiologically conceivable but did not support the prescription of P/G. High discontinuation rates were observed (85%). Among the patients who had discontinued the drug, 61.1% did not receive follow-up prescriptions within 2 years.

CONCLUSION:

The results show that P/G is widely prescribed in cases of chronic pain irrespective of neuropathic pain diagnoses. The high discontinuation rate indicates a lack of therapeutic benefits and/or the occurrence of adverse effects.

• Authors: Annika Viniol, Tina Ploner, Lennart Hickstein, Jörg Haasenritter, Karl Martin Klein, Jochen Walker, Norbert Donner-Banzhoff, Annette Becker
• Journal: BMJ open (BMJ Open) Vol. 9 Issue 3 Pg. e021535 (03 30 2019) ISSN: 2044-6055 [Electronic] England
• PMID: 30928920 (Publication Type: Journal Article)
• Copyright: © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Chemical References

• Analgesics
• Pregabalin
• Gabapentin

Topics

• Adult
• Aged
• Analgesics (therapeutic use)
• Chronic Pain (drug therapy, epidemiology, etiology)
• Female
• Gabapentin (therapeutic use)
• Germany (epidemiology)
• Humans
• Infant
• Insurance Claim Review
• Male
• Neuralgia (drug therapy, epidemiology)
• Pain Management (methods, statistics & numerical data)
• Practice Patterns, Physicians' (statistics & numerical data)
• Pregabalin (therapeutic use)
• Primary Health Care (methods, statistics & numerical data)
• Withholding Treatment (statistics & numerical data)