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

Abstract

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.

A systematic review of cost-effectiveness modeling of pharmaceutical therapies in neuropathic pain: variation in practice, key challenges, and recommendations for the future

“…The search identified 797 studies, 20 of which met the inclusion criteria. Of the 20 included studies, 14 presented original model structures 4,5,[16][17][18][19][20][21][22][23][24]27,29,30 , and six used existing model structures populated with data and assumptions that differed from those in the original study 3,25,26,[31][32][33] . Herein, where data and scope are compared, we refer to all 20 included studies, but where model type and structural elements are compared, we compare across the 14 original model structures only.…”

“…Results in Table 1 suggest that the volume of cost-effectiveness studies in neuropathic pain is increasing; over 50% of the 20 inclusions (11 studies) were published after January 2010 [3][4][5]17,19,20,25,29,[31][32][33] . This may reflect an emergence of new treatments for neuropathic pain, and an increasing need across jurisdictions to demonstrate cost-effectiveness in order to receive reimbursement for these types of therapies.…”

“…The majority of studies identified were European [3][4][5]16,18,[24][25][26]29,[31][32][33] . Pregabalin is the most commonly appraised analgesic across these studies, assessed in all except two European studies 18,24 .…”

“…A key challenge in capturing health outcomes for costeffectiveness modeling in neuropathic pain is overcoming the use of relative measures of pain improvement as primary outcomes in cost-effectiveness models. Table 1 illustrates how seven model structures from eight studies 3,5,[17][18][19]21,29,30 have used categories of relative pain relief to measure clinical effectiveness. Defining pain status in relative terms implicitly ensures that patients achieving the same proportion of pain relief are regarded the same, irrespective of their baseline pain levels.…”

“…It may be defined as pain resulting as a direct consequence of a lesion or disease that affects the somatosensory system 2 , but it can have many underlying causes, leading to a categorization of sub-types. The most common of these are post-herpetic pain and pain occurring as a result of diabetes 3,4 . Neuropathic pain is also associated with many other diseases, including trigeminal neuralgia, multiple sclerosis, spinal cord injury, HIV, and cancer 5 .…”