PMU55 - CONSEQUENCES ON ECONOMIC OUTCOMES OF GENERIC VERSUS BRAND-NAME DRUGS USED IN ROUTINE CLINICAL PRACTICE: THE CASE OF TREATING PERIPHERAL NEUROPATHIC PAIN OR GENERALIZED ANXIETY DISORDER WITH PREGABALIN

To provide real-world evidence on treatment persistence and economic and clinical consequences of generic versus brand-name pregabalin routinely used to treat peripheral neuropathic pain (pNP) or generalized anxiety disorder (GAD). Real-world secondary data analysis of electronic-medical-records (EMR) abstracted from a database including primary healthcare centers in Spain. Brand-name (Lyrica®) and generic pregabalin data from subjects’ first starting treatment for pNP or GAD between January-2015 and June-2016 were used. Main outcomes included treatment persistence (time-to-discontinuation), medication possession ratio (MPR), healthcare and non-healthcare resource utilization, and corresponding costs. Remitter and responder rates were also assessed. A total of 4,860 EMRs of patients >18 years-old with pNP (79.1% brand-name, 20.9% generic) and 990 with GAD (68.1% brand-name, 31.9% generic) were analyzed. Discontinuation was lower with brand-name than with generic pregabalin in pNP (adjusted hazard ratio [HR]: 0.70 [95% CI: 0.58–0.85], p<0.001) and GAD patients (HR: 0.63 [0.45–0.84], p<0.001). MPR was higher for brand-name: 83.6% vs. 78.4% in pNP and 81.8% vs. 76.5% in GAD (both p<0.001). Per-patient adjusted mean total costs were lower with brand-name: €1,500 [1,428–1,573] vs. €2,003 [1,864–2,143] in pNP and €1,528 [1,322–1,734] vs. €2,150 [1,845–2,454] in GAD (both p<0.001). More patients were remitters or responders with brand-name versus generic in pNP (55.0% [53.4%–56.6%] vs. 46.7% [43.6%–49.7%] and 59.2% [57.7%–60.8%] vs. 48.4% [45.4%–51.5%], respectively; p<0.001) and GAD (58.6% [54.9%–62.3%] vs. 48.7% [43.2%–53.3%] and 64.6% [60.9%–68.1%] vs. 47.2% [41.7%–52.7%], respectively; p<0.001). Meaningful and significantly higher treatment adherence was found in patients with pNP or GAD who first started therapy with brand-name versus generic pregabalin in routine practice in Spain. Consequently, patients receiving brand-name pregabalin showed better outcomes in terms of pain or anxiety at a lower cost to payers.