AB122. 127. Prevalence of off-label prescribing of versace patches for musculoskeletal pain in a university teaching hospital

Background: Nationally, 5% of the population have been prescribed lidocaine patches (Versatis). These patches cost €77–€230 per month and have been nicknamed ‘Versace patches’ by the pharmaceutical industry. The only licensed indication for Versatis is post-herpetic neuralgia (PHN). It has not proven to be effective for any other indication including musculoskeletal and post-surgical pain. It is estimated that only 5–10% of patients on Versatis have PHN. The aim of this study was to audit the number of inpatients currently prescribed Versatis—appropriately and inappropriately—and to examine the prescribing patterns.

Methods: The acute inpatient population was audited to determine Versatis prevalence. Demographics, indication, prescriber grade and whether Versatis therapy was commenced during the current admission were recorded.

Results: There were 304 patients included in the study. The mean age was 70. There were 28 females and 24 males prescribed Versatis, 38 medical and 14 surgical patients. Musculoskeletal pain 73% (n=38) was the most common indication. Post-operative pain 5.7% (n=3), and chest pain 3.8% (n=2) were also documented indications. No patients were prescribed Versatis for PHN. Fifty-two percent (n=27) of patients commenced Versatis therapy during their current inpatient stay. The most frequent prescribers were registrars (n=9) followed by interns (n=6). Based on current levels of usage the cost to the hospital is €48,050–€143,520 per annum.

Conclusions: A large proportion of inpatients are inappropriately prescribed Versatis patches predominantly for musculoskeletal pain, resulting in substantial avoidable cost to the hospital. Education of prescribers and implementation of policies is required to limit inappropriate prescribing.

Keywords: Versatis; patch; musculoskeletal; pain