Cost analysis of adding pregabalin or gabapentin to the management of community-treated patients with peripheral neuropathic pain
Article first published online: 30 AUG 2011
© 2011 Blackwell Publishing Ltd
Journal of Evaluation in Clinical Practice
Volume 18, Issue 6, pages 1170–1179, December 2012
How to Cite
Sicras-Mainar, A., Rejas-Gutiérrez, J., Navarro-Artieda, R. and Planas-Comes, A. (2012), Cost analysis of adding pregabalin or gabapentin to the management of community-treated patients with peripheral neuropathic pain. Journal of Evaluation in Clinical Practice, 18: 1170–1179. doi: 10.1111/j.1365-2753.2011.01752.x
- Issue published online: 29 OCT 2012
- Article first published online: 30 AUG 2011
- Accepted for publication: 13 June 2011
- health care resources;
- peripheral neuropathic pain;
- population-oriented setting;
- routine medical practice;
- sick leave
Objective To compare the cost of adding either pregabalin or gabapentin to the management of community-treated patients with peripheral neuropathic pain (PNP).
Methods A retrospective observational study was conducted using medical records from a Spanish health care provider claims database. Patients receiving health care for PNP, above 18 years and for which either pregabalin or gabapentin was initiated between 2006 and 2008 were included. Economic evaluation included health care resource utilization costs and costs due to sick leave.
Results A total of 1163 patients with PNP were eligible for analysis: 764 were prescribed pregabalin and 399 gabapentin in addition to current pain therapy. Mean age was 59.2 years and 62.2% were female. Concomitant use of analgesics was higher in the gabapentin cohort (3.2 vs. 2.7; P = 0.003), mainly due to non-steroidal anti-inflammatory drugs (74.9% vs. 69.5%; P = 0.018) and opioids (27.7% vs. 17.9%; P = 0.031). Adjusted total costs per patient was lower in pregabalin-treated patients (€2514 vs. €3241; P = 0.003), due to less sick leave (€1067 vs. €1633; P = 0.018) and lower health care costs (€1447 vs. €1609; P = 0.004). The higher acquisition cost of pregabalin (€351 vs. €191; P < 0.001) was largely compensated with lower costs in medical visits, physiotherapy, hospital stays and concomitant analgesics.
Conclusions In community-treated patients with PNP, total costs were considerably less for those patients initiated with pregabalin therapy than for those patients starting gabapentin add-on therapy. The relatively higher treatment acquisition cost of pregabalin was largely compensated by the overall lower costs for the other components of health care resources and sick leave, thus reducing the economic impact on the health care provider's budget and society.