Vol.:(0123456789) Applied Health Economics and Health Policy https://doi.org/10.1007/s40258-020-00586-5 ORIGINAL RESEARCH ARTICLE Efect of an Online Reimbursement Application System on Prescribing of Lidocaine 5% Medicated Plaster in the Republic of Ireland Amelia Smith 1,2  · Stephen Doran 1,2  · Maria Daly 1,2  · Cormac Kennedy 1  · Michael Barry 1,2 © Springer Nature Switzerland AG 2020 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 of-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 efect 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 car- ried 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 signifcant 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 reim- bursement 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. * Amelia Smith smitha25@tcd.ie 1 Department of Pharmacology and Therapeutics, Trinity College Dublin, Trinity Centre for Health Sciences, St. James’ Hospital, Dublin 8, Ireland 2 Medicines Management Programme, Health Service Executive, St. James’ Hospital, Dublin 8, Ireland Key Points for Decision Makers Increased trends in Versatis ® utilization and expenditure suggests that there was considerable of-label use of this product A reimbursement application system could be useful to not only reduce expenditure for the healthcare payer, but to ensure evidence-based use of medicines  The rate of Versatis ® prescribing dropped from 13.6 per 1000 eligible population in August 2017 to 0.89 per 1000 eligible population in August 2018  Expenditure on Versatis ® was reduced from €28 million in 2016 to €2 million in 2018 1 Introduction In 2013, the Irish Health Service Executive (HSE) estab- lished the Medicines Management Programme (MMP), with the role of providing sustained leadership in relation to evidence-based, cost-efective and safe prescribing. The MMP has been responsible for a number of on-going ini- tiatives in Ireland, including the publication of Prescrib- ing and Cost Guidance documents to inform prescribers and other healthcare professionals on the costs associated with medicines, and to encourage the prescribing of less expensive, equally efective therapies for patients where possible. In March 2017, the MMP published a Prescrib- ing and Cost Guidance document on the lidocaine 5%