Effect of an Online Reimbursement Application System on Prescribing of Lidocaine 5% Medicated Plaster in the Republic of Ireland

Abstract

Background The lidocaine 5% medicated plaster, Versatis^®, has one therapeutic indication listed on the Summary of Product Characteristics—symptomatic relief of post-herpetic neuralgia (PHN) in adults. Increased expenditure on Versatis^® suggests that there is considerable off-label use. To support the appropriate use of Versatis^®, the Health Service Executive’s Primary Care Reimbursement Service (PCRS) introduced a reimbursement application system for Versatis^® from 1 September 2017. Objective The aim of this study was to investigate the effect of introducing a reimbursement application system on Versatis^® prescribing under the General Medical Services (GMS) scheme. Methods This study was carried out using prescription dispensing data from the PCRS pharmacy claims database. We carried out segmented linear regression to assess changes in the Versatis^® prescribing rate per 1000 GMS eligible population, before and after the introduction of the online reimbursement application system. Results The results of the segmented regression analysis show that there was a statistically significant level (− 4.91, p < 0.001) and trend change (− 0.69, p < 0.001) in the rate of Versatis^® prescribing post-introduction of the reimbursement application system. In the year prior to the introduction of the system, 2016, the annual GMS expenditure on Versatis^® lidocaine 5% patches was over €27 million, whereas the GMS expenditure in 2018 was reduced to just over €2 million. Conclusion In our study, a substantial decrease in the dispensing of Versatis^® was seen after the implementation of a reimbursement application system. Prescribing of Versatis^® should be restricted to patients with a diagnosis of PHN not only to reduce costs, but to ensure evidence-based use of this medication.