title: Effect of pregabalin in the treatment of refractory neck pain: cost and clinical evidence from medical practice in orthopedic surgery and rehabilitation clinics.
abstract: BACKGROUND
  The study aims to prospectively analyze the effect of adding pregabalin upon costs and consequences in the treatment of refractory neck pain under routine medical practice.
  
  
  METHODS
  A secondary analysis was carried out including patients over 18 years, with 6-month chronic neck pain refractory from a prospective, naturalistic, 12-week two-visit study. The analysis compared patients adding pregabalin to its therapy vs. usual care. Severity of pain, healthcare resources utilization, lost workday equivalents (LWDE) because of pain, and related cost-adjusted reductions were assessed.
  
  
  RESULTS
  A total of 312 patients (65.3% women, age 54.2 [12.1] years), 78.2% receiving pregabalin, were analyzed. Adding pregabalin was associated with higher adjusted reduction in pain severity: -3.2 (1.8) points, 55.4% responders (≥50% baseline pain reduction) vs. -2.3 (2.0) and 38.2%, respectively; P<0.001, yielding a higher reduction in mean LWDE: 20.1 (23.1) vs. 8.2 (22.4); P=0.014, which produced significant reductions in the indirect components of cost: €1,041.0 (1,222.8) vs. €457.3 (1,132.1), P=0.028. The costs of pregabalin (€309.8 [193.2] vs. €26.4 [79.6], P<0.001) was offset by higher numerical reductions in the other components of costs, producing similar direct cost reductions in both groups at the end of the study: €66.8 (1,080.8) and €143.5 (1,922.4), respectively; P=0.295.
  
  
  CONCLUSIONS
  Compared with usual care, the addition of pregabalin to treat refractory neck pain seems to be associated with a higher reduction in pain severity and lost work-days equivalents, which in turn results in a greater reduction of the indirect components of cost while maintaining similar healthcare cost levels despite its higher price.
authors.affiliation: Rehabilitation Unit, Foundation Hospital Alcorcón, Madrid, Spain. MFlorez@fhalcorcon.es
authors.forename: Mariano
authors.initials: M
authors.lastname: Flórez-García
authors.forename: Félix
authors.initials: F
authors.lastname: Ceberio-Balda
authors.forename: Carles
authors.initials: C
authors.lastname: Morera-Domínguez
authors.forename: Xavier
authors.initials: X
authors.lastname: Masramón
authors.forename: María
authors.initials: M
authors.lastname: Pérez
mesh_terms: D000328:Adult; D000368:Aged; D000700:Analgesics / Q000191:economics / Q000627:therapeutic use*; D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000188:drug therapy* / Q000191:economics; D019637:Orthopedic Procedures / Q000191:economics; D010148:Intractable Pain / Q000188:drug therapy* / Q000191:economics; D000069583:Pregabalin; D011446:Prospective Studies; D016896:Treatment Outcome; D005680:gamma-Aminobutyric Acid / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use
chemical_list: D000700:Analgesics; D000069583:Pregabalin; D005680:gamma-Aminobutyric Acid