Cost analysis of adding pregabalin or gabapentin to the management of community‐treated patients with peripheral neuropathic pain

Abstract

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.

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

“…There have been very few economic studies conducted in Spain or other countries comparing the cost of treatment of PNP with pregabalin and gabapentin, and we are not aware of any with our study's objective. Before loss of data exclusivity, the total cost of PNP per patient was around €728 lower in those treated with pregabalin than in those receiving gabapentin during the 2 years of follow‐up of the patients, €162 of which was for the health care cost component 21. This difference (statistically significant, P  = 0.003) was explained by lower use of health care resources (mainly medical visits and concomitant analgesic medication) in the patients who received pregabalin in comparison with gabapentin, which clearly offset the greater cost of acquiring pregabalin versus gabapentin (see Figure 1).…”

“…This difference (statistically significant, P  = 0.003) was explained by lower use of health care resources (mainly medical visits and concomitant analgesic medication) in the patients who received pregabalin in comparison with gabapentin, which clearly offset the greater cost of acquiring pregabalin versus gabapentin (see Figure 1). 21 Although loss of data exclusivity has caused a considerable reduction of funded and public prices for both pregabalin and gabapentin since then, there is still a relevant gap in their cost when used to treat PNP in routine medical practice in Spain. However, because of the reduction observed in the price of concomitant analgesic medication between the 2 analyses, the combined cost for all analgesic medication, which before was practically equal (€572 with pregabalin vs €575 with gabapentin), has been considerably reduced at present, especially in the pregabalin group; €391 vs €464, P  < 0.05 (Figure 1).…”

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

“…The database from a prior study was used to conduct this study [10]. A retrospective observational design was chosen, wherein the electronic medical records of patients of six primary care centers and their referral hospital were reviewed.…”

“…Although they differ in their pharmacokinetic properties and formulations, in clinical trials both drugs have demonstrated the capacity to reduce PNP, with similar tolerability profiles [7]. Nevertheless, under routine clinical practice conditions, significant differences have been noted between the two molecules in the treatment of chronic PNP depending on whether branded or generic versions of the same active substance are used [8], with loss of exclusivity of the drugs' reference prices [9], and even the effects of age and gender on clinical and economic consequences in the treatment of PNP [8,10]. Some patients do not receive the appropriate pharmacological treatment, or the doses prescribed are lower than recommended doses [1,2,5,6,11,12].…”

“…Some of the reasons for failing to meet the recommended doses may include difficulty taking the number of doses prescribed, where the regimen is particularly onerous, for example where patients are taking multiple medications, or due to limitations of the pharmaceutical formulation that make it especially difficult to achieve doses in the therapeutic range under routine clinical practice conditions [5,6,11,12]. For these reasons, there is little available evidence on the prescription of the recommended doses for the treatment of PNP in routine clinical practice (such evidence is only available from clinical trials), making this study particularly relevant [10].…”