Tags

Type your tag names separated by a space and hit enter

Pregabalin and gabapentin in matched patients with peripheral neuropathic pain in routine medical practice in a primary care setting: Findings from a cost-consequences analysis in a nested case-control study.

Abstract

BACKGROUND

Pregabalin and gabapentin are marketed to treat peripheral neuropathic pain, but head-to-head comparison is lacking.

OBJECTIVES

The aims of this work were to compare the effects of pregabalin and gabapentin on different patient-reported health outcomes and to analyze health care and nonhealth-care resource consumption and their related costs among patients treated for peripheral neuropathic pain in primary medical care.

METHODS

A cost-consequences comparison in subjects with refractory (suboptimal response to > or =1 previous analgesic treatment for >6 months) chronic peripheral neuropathic pain was carried out using data extracted from two 12-week, observational, prospective studies in primary medical care. Patients were eligible if they were aged > or =18 years, had a score of > or =4 on the Douleur Neuropathique 4 questionnaire, and were able to complete health questionnaires written in Spanish. A nested-paired case-control design was chosen to perform the comparison with 2 controls (pregabalin) per case (gabapentin) matched by age, sex, peripheral neuropathic pain condition, time since diagnosis, number of previous treatments, pain intensity, depressive and anxiety symptom scores, and health state. Adult subjects with refractory chronic pain because of diabetic neuropathy, postherpetic or trigeminal neuralgias, or cervical or lumbosacral radiculopathies were included. Epidemiologic statistical methods were applied for comparing health effects (pain intensity, sleep, anxiety and depressive symptoms, disability, and health state), resources utilization, and related cost variations after 12 weeks. Indirect costs were measured by means of lost-workday equivalent calculations multiplied by the mean national daily salary.

RESULTS

Analysis included 44 patients treated with gabapentin (cases) and 88 patients treated with pregabalin (controls) who were matched for age, sex, and other parameters. The mean (SD) gabapentin and pregabalin doses were 1263 (540) and 202 (119) mg/d, respectively. Although there was a greater reduction in last-week mean pain intensity with pregabalin (visual analog scale: 39.1 [22.5] vs 28.0 [22.2] mm; P = 0.008), as well as more patients with a > or =50% reduction in pain rate (60.9% vs 40.5%; P = 0.029), there were no significant differences between groups for sensory, affective, total, or present pain intensity. The significantly higher drug cost associated with pregabalin was offset by a greater reduction in productivity costs compared with gabapentin, yielding similar cost reduction (-euro1254 [1479] vs -euro1384 [2874], respectively; P = NS).

CONCLUSION

Pregabalin appeared to be associated with greater reduction in mean weekly intensity of pain, but there were no significant differences in cost.

Links

  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Hospital Universitario de la Princesa, Madrid, Spain. cperez.hlpr@salud.madrid.org

    , , ,

    Source

    Clinical therapeutics 32:7 2010 Jul pg 1357-70

    MeSH

    Aged
    Amines
    Analgesics
    Case-Control Studies
    Clinical Trials as Topic
    Cyclohexanecarboxylic Acids
    Drug Costs
    Efficiency
    Female
    Gabapentin
    Health Care Costs
    Humans
    Male
    Middle Aged
    Pain Measurement
    Peripheral Nervous System Diseases
    Pregabalin
    Primary Health Care
    gamma-Aminobutyric Acid

    Pub Type(s)

    Comparative Study
    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    20678683

    Citation

    Pérez, Concepción, et al. "Pregabalin and Gabapentin in Matched Patients With Peripheral Neuropathic Pain in Routine Medical Practice in a Primary Care Setting: Findings From a Cost-consequences Analysis in a Nested Case-control Study." Clinical Therapeutics, vol. 32, no. 7, 2010, pp. 1357-70.
    Pérez C, Navarro A, Saldaña MT, et al. Pregabalin and gabapentin in matched patients with peripheral neuropathic pain in routine medical practice in a primary care setting: Findings from a cost-consequences analysis in a nested case-control study. Clin Ther. 2010;32(7):1357-70.
    Pérez, C., Navarro, A., Saldaña, M. T., Masramón, X., & Rejas, J. (2010). Pregabalin and gabapentin in matched patients with peripheral neuropathic pain in routine medical practice in a primary care setting: Findings from a cost-consequences analysis in a nested case-control study. Clinical Therapeutics, 32(7), pp. 1357-70. doi:10.1016/j.clinthera.2010.07.014.
    Pérez C, et al. Pregabalin and Gabapentin in Matched Patients With Peripheral Neuropathic Pain in Routine Medical Practice in a Primary Care Setting: Findings From a Cost-consequences Analysis in a Nested Case-control Study. Clin Ther. 2010;32(7):1357-70. PubMed PMID: 20678683.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Pregabalin and gabapentin in matched patients with peripheral neuropathic pain in routine medical practice in a primary care setting: Findings from a cost-consequences analysis in a nested case-control study. AU - Pérez,Concepción, AU - Navarro,Ana, AU - Saldaña,María T, AU - Masramón,Xavier, AU - Rejas,Javier, PY - 2010/05/26/accepted PY - 2010/8/4/entrez PY - 2010/8/4/pubmed PY - 2010/12/14/medline SP - 1357 EP - 70 JF - Clinical therapeutics JO - Clin Ther VL - 32 IS - 7 N2 - BACKGROUND: Pregabalin and gabapentin are marketed to treat peripheral neuropathic pain, but head-to-head comparison is lacking. OBJECTIVES: The aims of this work were to compare the effects of pregabalin and gabapentin on different patient-reported health outcomes and to analyze health care and nonhealth-care resource consumption and their related costs among patients treated for peripheral neuropathic pain in primary medical care. METHODS: A cost-consequences comparison in subjects with refractory (suboptimal response to > or =1 previous analgesic treatment for >6 months) chronic peripheral neuropathic pain was carried out using data extracted from two 12-week, observational, prospective studies in primary medical care. Patients were eligible if they were aged > or =18 years, had a score of > or =4 on the Douleur Neuropathique 4 questionnaire, and were able to complete health questionnaires written in Spanish. A nested-paired case-control design was chosen to perform the comparison with 2 controls (pregabalin) per case (gabapentin) matched by age, sex, peripheral neuropathic pain condition, time since diagnosis, number of previous treatments, pain intensity, depressive and anxiety symptom scores, and health state. Adult subjects with refractory chronic pain because of diabetic neuropathy, postherpetic or trigeminal neuralgias, or cervical or lumbosacral radiculopathies were included. Epidemiologic statistical methods were applied for comparing health effects (pain intensity, sleep, anxiety and depressive symptoms, disability, and health state), resources utilization, and related cost variations after 12 weeks. Indirect costs were measured by means of lost-workday equivalent calculations multiplied by the mean national daily salary. RESULTS: Analysis included 44 patients treated with gabapentin (cases) and 88 patients treated with pregabalin (controls) who were matched for age, sex, and other parameters. The mean (SD) gabapentin and pregabalin doses were 1263 (540) and 202 (119) mg/d, respectively. Although there was a greater reduction in last-week mean pain intensity with pregabalin (visual analog scale: 39.1 [22.5] vs 28.0 [22.2] mm; P = 0.008), as well as more patients with a > or =50% reduction in pain rate (60.9% vs 40.5%; P = 0.029), there were no significant differences between groups for sensory, affective, total, or present pain intensity. The significantly higher drug cost associated with pregabalin was offset by a greater reduction in productivity costs compared with gabapentin, yielding similar cost reduction (-euro1254 [1479] vs -euro1384 [2874], respectively; P = NS). CONCLUSION: Pregabalin appeared to be associated with greater reduction in mean weekly intensity of pain, but there were no significant differences in cost. SN - 1879-114X UR - https://www.unboundmedicine.com/medline/citation/20678683/Pregabalin_and_gabapentin_in_matched_patients_with_peripheral_neuropathic_pain_in_routine_medical_practice_in_a_primary_care_setting:_Findings_from_a_cost_consequences_analysis_in_a_nested_case_control_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0149-2918(10)00241-9 DB - PRIME DP - Unbound Medicine ER -