Pregabalin: 24 month predicted versus actual analysis

Page last updated: 4 March 2016

Drug utilisation sub-committee (DUSC)

October 2015

Abstract

Purpose

To examine the utilisation of pregabalin for neuropathic pain in the 24 months after PBS listing (1 March 2013 to 28 February 2015).

Data Source / methodology

Data for pregabalin was extracted from the DUSC and Department of Human Services (DHS) prescription databases from the date of listing of pregabalin on the Repatriation PBS (RPBS) Schedule (1 February 2008) to the most current available data (March 2015, inclusive).

Key Findings

  • There were 294,747 and 433,324 PBS/RPBS patients treated with PBS subsidised pregabalin in the first two years of listing respectively. This was 39% and 58% higher than predicted. The number of actual patients in Year 2 exceeds the number of patients predicted for Year 5.
  • The total number of prescriptions of pregabalin supplied in Year 1 (1,396,766) was similar to predicted, however utilisation in Year 2 (2,435,807 prescriptions) was 32% more than predicted.
  • The greater than predicted number of patients and prescriptions in Year 2 did not translate to significantly greater than predicted PBS & RPBS (R/PBS) expenditure because there was;
    - a higher than expected discontinuation rate after the first prescription leading to lower than expected prescriptions per patient; and
    - lower than expected R/PBS expenditure per prescription due to lower than expected average daily dose and higher than expected average patient copayment (due to higher than expected proportion of non-concessional patients).
  • Prescribing of pregabalin in clinical practice may not be optimal. A large number of patients do not have the dose of pregabalin up-titrated and persistence to therapy is poor.

Full Report