• Stephen S Johnston, Margarita Udall, Joseph C Cappelleri, Barbara H Johnson, George Shrady, Bong-Chul Chu, and Stuart L Silverman.
• Stephen S. Johnston, M.A., is Research Leader, Truven Health Analytics, Bethesda, MD. Margarita Udall, M.P.H., is Associate Director; and Joseph C. Cappelleri, M.P.H., Ph.D., is Senior Director, Pfizer, New York, NY. Barbara H. Johnson, M.B.A., is Analyst Manager; George Shrady, M.S., is Programmer; and Bong-Chul Chu, Ph.D., is Senior Statistician, Truven Health Analytics. Stuart L. Silverman, M.D., FACP, FACR, is Medical Director, Bone Health Center, Cedars-Sinai Medical Center, Los Angeles, CA.
• Am J Health Syst Pharm. 2013 Dec 15;70(24):2207-17.

PurposeThe frequency and financial impact of potential drug-drug interactions (DDIs) and drug-condition interactions (DCIs) in patients with painful diabetic peripheral neuropathy (DPN) treated with either pregabalin or duloxetine were compared.MethodsThis retrospective cohort study was conducted using a large U.S. administrative claims database. Patients selected for study inclusion had a diagnosis of DPN and were newly initiated on either pregabalin or duloxetine between July 1, 2008, and October 1, 2010. Data on potential DDIs and DCIs were collected. Health care costs were measured as the sum of gross covered payments for all medical and prescription claims incurred during the six months after the index date.ResultsThe study sample comprised 2499 pregabalin users and 1354 duloxetine users. Among pregabalin users, 48 (1.8%) had at least one potential pregabalin DCI; none had potential pregabalin DDIs. Among duloxetine users, 966 (71%) had at least one potential duloxetine DDI or DCI. The frequencies of potential DDIs and DCIs differed significantly between pregabalin and duloxetine users (p < 0.001). Potential duloxetine DDIs and DCIs were associated with a significant increase in mean health care costs in duloxetine users (p = 0.002). Potential pregabalin DDIs and DCIs were not associated with additional health care costs in pregabalin users.ConclusionAmong patients with painful DPN treated with either pregabalin or duloxetine, the frequency of potential duloxetine DDIs and DCIs was substantially higher than that of pregabalin. Potential DDIs and DCIs were associated with significantly increased health care costs in duloxetine users.

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