Cost-utility of pregabalin as add-on to usual care versus usual care alone in the management of peripheral neuropathic pain in Belgium

Chevalier, Pierre; Lamotte, M; Campenhout, H Van; Eyckerman, Roman; Annemans, Lieven

doi:10.3111/13696998.2013.773333

Cited by 6 publications

(15 citation statements)

References 21 publications

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“…Also, we cannot rule out completely that patients who are treated with gabapentin under routine medical practice are difficult to be treated to higher dosages such as the one observed in randomized clinical trial with such drug. The results observed in our retrospective study are consistent with other series published in the scientific literature either in Spain [19,20], and elsewhere as well [21][22][23][24]. All of such references, irrespectively of the economic type of study (cohort observational trial, economic modeling or clinical trial) have shown that in different types of PNP, pregabalin therapy is normally associated with lower healthcare resources utilization and fewer days of sick leave in comparison with gabapentin leading to a lower economic impact to the National Health System budgets, which is relevant when health decision is taken on a routine basis.…”

Section: Discussionsupporting

confidence: 93%

Cost of treating peripheral neuropathic pain with pregabalin or gabapentin at therapeutic doses in routine practice

Sicras‐Mainar¹,

Rejas‐Gutiérrez

Pérez‐Páramo

et al. 2018

J. Comp. Eff. Res.

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Aim:To analyze the cost of peripheral neuropathic pain (PNP) treatment with pregabalin or gabapentin at therapeutic doses in routine clinical practice. Methods: Analysis of a retrospective, observational study of electronic medical records of patients treated for PNP with therapeutic doses of pregabalin or gabapentin, with 2 years' follow-up, considering PNP type, comorbidities, concomitant analgesia and resource use. Results: The weighted total average cost/patient was lower for pregabalin than gabapentin (€2464 vs €3142 [2670-3614]; p = 0.014) due to significantly lower both healthcare and non-healthcare costs. This is explained by a significantly lower use of concomitant analgesia, fewer primary care visits and fewer days of sick leave. Conclusion: At therapeutic doses, pregabalin was found to have lower healthcare and non-healthcare costs than gabapentin in routine practice.

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Section: Discussionsupporting

confidence: 93%

Cost of treating peripheral neuropathic pain with pregabalin or gabapentin at therapeutic doses in routine practice

Sicras‐Mainar¹,

Rejas‐Gutiérrez

Pérez‐Páramo

et al. 2018

J. Comp. Eff. Res.

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“…It is one of the series with the highest number of subjects studied, which should be interpreted as a study strength 31, 32, 33, 34, 35, 36. However, it should be noted that without appropriate standardization of patient characteristics, as well as in the number and extent of the variables studied, the results obtained should be interpreted with caution, and care should be taken in the external validation of the results.…”

Section: Discussionmentioning

confidence: 99%

Cost of treatment of peripheral neuropathic pain with pregabalin or gabapentin in routine clinical practice: impact of their loss of exclusivity

Sicras‐Mainar¹,

Rejas‐Gutiérrez

Pérez‐Páramo

et al. 2016

Evaluation Clinical Practice

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To analyze the effect of loss of exclusivity of data on the cost of treatment of peripheral neuropathic pain (PNP) with pregabalin or gabapentin in routine clinical practice. A retrospective observational study, with electronic medical records for patients enrolled at primary care centers managed by the health care provider Badalona Serveis Assistencials, who initiated treatment of PNP with pregabalin or gabapentin. The analysis used drugs and resources prices for year 2015. The 1163 electronic medical records (pregabalin; N = 764, gabapentin; N = 399) for patients (62.2% women) with a mean (standard deviation) age of 59.2 (14.7) years were analyzed. Treatment duration was slightly shorter with pregabalin than with gabapentin (5.2 vs 5.5 months; P = 0.124), with mean doses of 227.4 (178.6) mg and 900.0 (443.4) mg, respectively. The average study drug cost per patient was higher for pregabalin than for gabapentin; €214.6 (206.3) vs €157.4 (181.9), P < 0.001, although the cost of concomitant analgesic medication was lower; €176.5 (271.8) vs €306.7 (529.2), P < 0.001. The adjusted average total cost per patient was lower in those treated with pregabalin than in those treated with gabapentin; €2,413 (2119‐2708) vs €3201 (2806–3.597); P = 0.002, owing to significantly lower health care costs; €1307 (1247‐1367) vs €1538 (1458‐1618), P < 0.001, and also non‐health care costs; €1106 (819‐1393) vs €1663 (1279‐2048), P = 0.023, that was caused by a significantly lower use of concomitant medication, fewer medical visits to primary care, and fewer days of sick leave. After loss of exclusivity of both drugs, pregabalin continued to show lower health care and non‐health care costs than gabapentin in the treatment of PNP in routine clinical practice.

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“…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.…”

Section: Figure 1 Presents a Preferred Reporting Items For Systematicmentioning

confidence: 99%

“…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.…”

Section: Figure 1 Presents a Preferred Reporting Items For Systematicmentioning

confidence: 99%

See 1 more Smart Citation

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

Critchlow

Hirst

Akehurst

et al. 2016

Journal of Medical Economics

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Objectives: Complexities in the neuropathic-pain care pathway make the condition difficult to manage and difficult to capture in cost-effectiveness models. The aim of this study is to understand, through a systematic review of previous cost-effectiveness studies, some of the key strengths and limitations in data and modeling practices in neuropathic pain. Thus, the aim is to guide future research and practice to improve resource allocation decisions and encourage continued investment to find novel and effective treatments for patients with neuropathic pain. Methods: The search strategy was designed to identify peer-reviewed cost-effectiveness evaluations of non-surgical, pharmaceutical therapies for neuropathic pain published since January 2000, accessing five key databases. All identified publications were reviewed and screened according to pre-defined eligibility criteria. Data extraction was designed to reflect key data challenges and approaches to modeling in neuropathic pain and based on published guidelines. Results: The search strategy identified 20 cost-effectiveness analyses meeting the inclusion criteria, of which 14 had original model structures. Cost-effectiveness modeling in neuropathic pain is established and increasing across multiple jurisdictions; however, amongst these studies, there is substantial variation in modeling approach, and there are common limitations. Capturing the effect of treatments upon health outcomes, particularly health-related quality-of-life, is challenging, and the health effects of multiple lines of ineffective treatment, common for patients with neuropathic pain, have not been consistently or robustly modeled. Conclusions: To improve future economic modeling in neuropathic pain, further research is suggested into the effect of multiple lines of treatment and treatment failure upon patient outcomes and subsequent treatment effectiveness; the impact of treatment-emergent adverse events upon patient outcomes; and consistent and appropriate pain measures to inform models. The authors further encourage transparent reporting of inputs used to inform cost-effectiveness models, with robust, comprehensive and clear uncertainty analysis and, where feasible, open-source modeling is encouraged. ARTICLE HISTORY

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Cost-utility of pregabalin as add-on to usual care versus usual care alone in the management of peripheral neuropathic pain in Belgium

Cited by 6 publications

References 21 publications

Cost of treating peripheral neuropathic pain with pregabalin or gabapentin at therapeutic doses in routine practice

Cost of treating peripheral neuropathic pain with pregabalin or gabapentin at therapeutic doses in routine practice

Cost of treatment of peripheral neuropathic pain with pregabalin or gabapentin in routine clinical practice: impact of their loss of exclusivity

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

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