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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.
- Source :
- Pain Medicine; May2012, Vol. 13 Issue 5, p699-710, 12p, 1 Diagram, 4 Charts, 2 Graphs
- Publication Year :
- 2012
-
Abstract
- 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. [ABSTRACT FROM AUTHOR]
- Subjects :
- DIAGNOSIS of diabetic neuropathies
HERPES zoster diagnosis
EVALUATION of medical care
MEDICAL practice
PATIENTS
TREATMENT of peripheral neuropathy
NEURALGIA
ACETAMINOPHEN
ACUPUNCTURE
ANALGESICS
CONFIDENCE intervals
COST effectiveness
DEMOGRAPHY
ECONOMICS
HEALTH care rationing
INJECTIONS
MEDICAL care costs
NARCOTICS
NONSTEROIDAL anti-inflammatory agents
PAIN
PHYSICAL therapy
PRIMARY health care
QUESTIONNAIRES
SCALES (Weighing instruments)
TOMOGRAPHY
TRIGEMINAL neuralgia
ULTRASONIC imaging
DATA analysis
MCGILL Pain Questionnaire
ACQUISITION of data
PREGABALIN
DESCRIPTIVE statistics
DIAGNOSIS
Subjects
Details
- Language :
- English
- ISSN :
- 15262375
- Volume :
- 13
- Issue :
- 5
- Database :
- Complementary Index
- Journal :
- Pain Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 75275878
- Full Text :
- https://doi.org/10.1111/j.1526-4637.2012.01375.x