Pharmaco-Epidemiology and Cost-Effectiveness of Lamotrigine in Daily Practice.
Abstract number :
1.294
Submission category :
Year :
2001
Submission ID :
172
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
P.D. Knoester, PharmD, Clinical Pharmacy, University Medical Center, Nijmegen, Netherlands; C.L.P. Deckers, MD,PhD, Clinical Pharmacy, University Medical Center, Nijmegen, Netherlands; Y.A. Hekster, PharmD,PhD, Clinical Pharmacy, University Medical Center
RATIONALE: A study was performed to assess the feasability of a pharmaco-epidemiological / pharmaco-economical study on lamotrigine (LTG) using prescription data from public pharmacies. The study consisted of two phases.
Phase 1: Pharmacoepidemiological characterization of LTG use.
Phase 2: Cost-effectiveness study on LTG in daily practice.
METHODS: Phase 1: the source population consisted of persons who filled at least one prescription for lamotrigine during January 1996 - June 2000. All prescriptions of these patients during that period were obtained after being made anonymous with respect to identity of the patient and prescriber. In total 30 community pharmacies, covering a population of about 300,000 persons, were asked to participate.
Phase 2: Eligible patients from phase 1 were sent a letter via their pharmacists, asking their permission to review their medical charts,. Effectiveness of lamotrigine was assessed by a composite measure: seizure frequency should have dropped by at least 50% after the start of LTG and patients should still be using LTG after twelve months. Direct medical costs were assessed using cost data described in the medical chart.
RESULTS: Phase 1: 150 LTG users were identified. There was a trend for lamotrigine to being prescribed increasingly early during treatment.
Phase 2: Sixty-one out of 104 eligible patients gave us permission to review their medical charts. Treatment was effective in 41% of patients. The direct medical costs per patient increased with $200 after the start of LTG. Therefore, the cost effectiveness ratio is $450.
CONCLUSIONS: 1. It is possible to identify and characterize LTG users using data from public pharmacies, without violating the privacy of patients. 2. These patients can be characterized using pharmaco-epdemiological tools. 3 Observational cost-effectiveness assessment of medical interventions is feasible using this approach.
Support: Dutch National Health Insurance Board