Análisis de coste-efectividad en el tratamiento farmacológico del síndrome de fibromialgia en México

Arreola-Ornelas, Héctor; Buzzo, Alfonso Rosado; Garcı́a, Lourdes; Aguilar, Javier Dorantes; Hernández, Iris Contreras; Quevedo, Joaquín F Mould

doi:10.1016/j.reuma.2011.12.009

Cited by 6 publications

(8 citation statements)

References 32 publications

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“…The time horizon was shorter than six months ( n = 3) [ 33 – 35 ], between six months and eight months ( n = 6) [ 30 , 36 – 40 ], between 14 months and two years ( n = 7) [ 32 , 41 – 46 ] or three to 20 years ( n = 5) [ 47 – 51 ]. The remaining studies had time horizons of one year ( n = 18) [ 31 , 52 – 68 ].…”

Section: Resultsmentioning

confidence: 99%

“…Data on study population and treatment alternatives are presented in Table 2 . Studies focused on patients with undifferentiated MUS ( n = 10) [ 31 – 33 , 41 , 46 , 48 , 54 – 57 ], on patients with FM ( n = 10) [ 30 , 36 , 37 , 42 , 47 , 52 , 53 , 58 – 60 ], on patients with IBS ( n = 11) [ 34 , 35 , 43 , 49 , 50 , 51 , 61 – 65 ], and on patients with CFS ( n = 8) [ 38 – 40 , 44 , 45 , 66 – 68 ].…”

Section: Resultsmentioning

confidence: 99%

“…Studies focusing on patients with FM ( n = 10) compared a pharmacological intervention with another pharmacological intervention ( n = 4) [ 42 , 47 , 52 , 53 ], a group-based therapy ( n = 2), acceptance and commitment therapy (ACT) [ 30 ] and cognitive behavioral therapy (CBT) [ 36 ] compared with a pharmacological intervention and treatment as usual or waiting list. An educational intervention ( n = 2) was compared with usual care or an educational discussion group [ 58 , 60 ] and an aquatic exercise program ( n = 1) [ 37 ] or spa treatment ( n = 1) [ 59 ] was compared with usual care.…”

Section: Resultsmentioning

confidence: 99%

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Cost-effectiveness of interventions for medically unexplained symptoms: A systematic review

et al. 2018

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BackgroundIn primary and secondary care medically unexplained symptoms (MUS) or functional somatic syndromes (FSS) constitute a major burden for patients and society with high healthcare costs and societal costs. Objectives were to provide an overview of the evidence regarding the cost-effectiveness of interventions for MUS or FSS, and to assess the quality of these studies.MethodsWe searched the databases PubMed, PsycINFO, the National Health Service Economic Evaluation Database (NHS-EED) and the CEA registry to conduct a systematic review. Articles with full economic evaluations on interventions focusing on adult patients with undifferentiated MUS or fibromyalgia (FM), irritable bowel syndrome (IBS) and chronic fatigue syndrome (CFS), with no restrictions on comparators, published until 15 June 2018, were included. We excluded preventive interventions. Two reviewers independently extracted study characteristics and cost-effectiveness data and used the Consensus on Health Economic Criteria Checklist to appraise the methodological quality.ResultsA total of 39 studies out of 1,613 articles met the inclusion criteria. Twenty-two studies reported costs per quality-adjusted life year (QALY) gained and cost-utility analyses (CUAs). In 13 CUAs the intervention conditions dominated the control conditions or had an incremental cost-effectiveness ratio below the willingness-to-pay threshold of € 50,000 per QALY, meaning that the interventions were (on average) cost-effective in comparison with the control condition. Group interventions focusing on MUS (n = 3) or FM (n = 4) might be more cost-effective than individual interventions. The included studies were heterogeneous with regard to the included patients, interventions, study design, and outcomes.ConclusionThis review provides an overview of 39 included studies of interventions for patients with MUS and FSS and the methodological quality of these studies. Considering the limited comparability due to the heterogeneity of the studies, group interventions might be more cost-effective than individual interventions.RegistrationStudy methods were documented in an international prospective register of systematic reviews (PROSPERO) protocol, registration number: CRD42017060424.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Cost-effectiveness of interventions for medically unexplained symptoms: A systematic review

et al. 2018

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“…In both studies, 58 , 59 the incremental cost-effectiveness ratios with pregabalin therapy was highest in patients with severe fibromyalgia and with 450 mg/day dosage. Studies from Iran 61 and Mexico 62 revealed consistent effects on cost saving, with most benefit with pregabalin 450 and 600 mg/day. 61 Comparative analyses of pregabalin and other drugs in fibromyalgia, especially duloxetine, have not always revealed consistent results with some studies pointing toward higher health care resource use with pregabalin, probably driven by more inpatient and outpatient visits and medication use, while others revealed nonsignificant difference between the two.…”

Section: Burden Of Fibromyalgiamentioning

confidence: 86%

“… 63 Almost all cost-effectiveness analyses are dominated by amitriptyline because of its lower costs but the comparison between amitriptyline and pregabalin relies on older studies which may not meet current quality criteria 59 and the degree of overall clinical improvement (reduction of VAS score by >50% and decrease in FIQ score by 30%) is lower with amityrptyline. 62 It may thus be stated that pregabalin therapy results in better outcomes at a higher cost when compared to amitriptyline. To conclude, long-term pregabalin therapy is certainly cost-effective in fibromyalgia especially at doses 450 mg/day or higher and at least cost neutral, if not cost saving, with 300 mg/day dose and is comparable to other drugs used in fibromyalgia.…”

Section: Burden Of Fibromyalgiamentioning

confidence: 99%

Clinical utility, safety, and efficacy of pregabalin in the treatment of fibromyalgia

Bhusal¹,

Diomampo²,

Magrey³

2016

DHPS

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Fibromyalgia is a chronic debilitating medical syndrome with limited therapeutic options. Pregabalin, an anticonvulsant and α-2-Δ subunit receptor ligand, is one of the anchor drugs approved by the US Food and Drug Administration for the treatment of fibromyalgia. The drug has shown clinically meaningful benefits across multiple symptom domains of fibromyalgia. Efficacy of pregabalin in fibromyalgia pain has been evaluated in at least five high-quality randomized trials, two long-term extension studies, a meta-analysis, a Cochrane database systematic review, and several post hoc analyses. These studies also hint towards a meaningful benefit on sleep, functioning, quality of life, and work productivity. Side effects of pregabalin, although common, are mild to moderate in intensity. They are noted early during therapy, improve or disappear with dose reduction, and are not usually life- or organ threatening. In most patients, tolerance develops to the most common side effects, dizziness, and somnolence, with time. With close clinical monitoring at initiation or dose titration, pregabalin can be effectively used in primary care setting. Pregabalin is cost saving with long-term use and its cost-effectiveness profile is comparable, if not better, to that of other drugs used in fibromyalgia. In the present era of limited therapeutic options, pregabalin undoubtedly retains its role as one of cardinal drugs used in the treatment of fibromyalgia. This review intends to discuss the clinical utility of pregabalin in the management of fibromyalgia with a focus on efficacy, safety, and cost-effectiveness.

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Effectiveness of a structured group intervention based on pain neuroscience education for patients with fibromyalgia in primary care: A multicentre randomized open‐label controlled trial

Barrenengoa‐Cuadra

Muñoa‐Capron‐Manieux

Fernández‐Luco

et al. 2021

European Journal of Pain

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Análisis de coste-efectividad en el tratamiento farmacológico del síndrome de fibromialgia en México

Cited by 6 publications

References 32 publications

Cost-effectiveness of interventions for medically unexplained symptoms: A systematic review

Cost-effectiveness of interventions for medically unexplained symptoms: A systematic review

Clinical utility, safety, and efficacy of pregabalin in the treatment of fibromyalgia

Effectiveness of a structured group intervention based on pain neuroscience education for patients with fibromyalgia in primary care: A multicentre randomized open‐label controlled trial

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