Document Detail


A cost-effectiveness analysis of the effect of pregabalin versus usual care in the treatment of refractory neuropathic pain in routine medical practice in Spain.
MedLine Citation:
PMID:  22594706     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The objective of this study was to estimate the cost-effectiveness of pregabalin vs usual care (UC) in outpatients with refractory neuropathic pain (NeP), treated according to routine medical practice in primary care settings in Spain.
METHODS: Patients were extracted from a 12-week noninterventional prospective study conducted to ascertain the costs of NeP. Pairs of pregabalin-naïve patients receiving UC or pregabalin, matched by age, gender, pain intensity, and refractory to previous treatment, were selected in a 1:1 ratio. Refractory was considered a patient with actual pain (scoring >40 in a 100 mm in a pain visual analog scale) after receiving a course of a standard analgesic, at its recommended doses. Perspectives of the Spanish National Healthcare System and society were included in the analysis. Effectiveness was expressed as quality-adjusted life-year (QALY) gain. Results of the cost-effectiveness analysis were expressed as an incremental cost per QALY (ICER) gained. Probabilistic sensitivity analysis using bootstrapping techniques was also carried out.
RESULTS: A total of 160 pairs were extracted. Compared with UC, pregabalin was associated with significantly higher QALY gain; 0.0374 ± 0.0367 vs 0.0224 ± 0.0313 (P < 0.001). Despite drug acquisition costs being higher for pregabalin (€251 ± 125 vs €104 ± 121; P < 0.001), total and health care costs incurred for pregabalin were similar in both groups; €1,335 ± 1,302 vs €1,387 ± 1,489 (P = 0.587) and €529 ± 438 vs €560 ± 672 (P = 0.628), respectively, yielding a dominant ICER for both total and health care costs in the base case scenario; 95% confidence intervals, respectively, dominant to €17,268, and dominant to €6,508. Sensitivity analysis confirmed results of the basecase scenario.
CONCLUSION: This study showed that pregabalin may be cost-effective in the treatment of refractory NeP patients when compared with UC in routine medical practice in Spain.
Authors:
Marina de Salas-Cansado; Concepción Pérez; María T Saldaña; Ana Navarro; Javier Rejas
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Pain medicine (Malden, Mass.)     Volume:  13     ISSN:  1526-4637     ISO Abbreviation:  Pain Med     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-05-18     Completed Date:  2012-09-20     Revised Date:  2013-08-21    
Medline Journal Info:
Nlm Unique ID:  100894201     Medline TA:  Pain Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  699-710     Citation Subset:  IM    
Copyright Information:
Wiley Periodicals, Inc.
Affiliation:
Health Outcomes Research Department, TFS, Madrid, Spain. marina.desalas@trialformsupport.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Analgesics / economics,  therapeutic use
Cost-Benefit Analysis
Female
Health Care Costs / trends*
Humans
Male
Middle Aged
Neuralgia / drug therapy,  economics*
Pain Measurement
Prospective Studies
Quality-Adjusted Life Years
Spain
gamma-Aminobutyric Acid / analogs & derivatives*,  economics,  therapeutic use
Chemical
Reg. No./Substance:
0/Analgesics; 55JG375S6M/pregabalin; 56-12-2/gamma-Aminobutyric Acid

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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