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

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.