title: Costs and health resources utilization following switching to pregabalin in individuals with gabapentin-refractory neuropathic pain: a post hoc analysis.
abstract: OBJECTIVE
  To analyze the changes in pain severity and associated costs resulting from resource utilization and reduced productivity in patients with gabapentin-refractory peripheral neuropathic pain who switched to pregabalin therapy in primary care settings in Spain.
  
  
  METHODS
  This is a post hoc analysis of a 12-week, multicentre, noninterventional cost-of-illness study. Patients were included in the study if they were over 18 years of age and had a diagnosis of chronic, treatment-refractory peripheral neuropathic pain. The analysis included all pregabalin-naïve patients who had previously shown an inadequate response to gabapentin and switched to pregabalin. Severity of pain before and after treatment with pregabalin, alone or as an add-on therapy, was assessed using the Short-Form McGill Pain Questionnaire (SF-MPQ) and its related visual analogue scale (VA). Healthcare resource utilization, productivity (including lost-workday equivalents [LWDE]), and related costs were assessed at baseline and after pregabalin treatment.
  
  
  RESULTS
  A total of 174 patients switched to pregabalin had significant and clinically relevant reductions in pain severity (mean [SD] change on SF-MPQ VA scale, -31.9 [22.1]; P < 0.05 vs. baseline; effect size, 1.87). Reduction in pain was similar with both pregabalin monotherapy and add-on therapy. Significant reductions in healthcare resource utilization (concomitant drug use [in pregabalin add-on group], ancillary tests, and unscheduled medical visits) were observed at the end of trial. Additionally, there were substantial improvements in productivity, including a reduction in the number of LWDE following pregabalin treatment (-18.9 [26.0]; P < 0.0001). These changes correlated with substantial reductions in both direct (-652.9 ± 1622.4 €; P < 0.0001) and indirect healthcare costs (-851.6 [1259.6] €; P < 0.0001).
  
  
  CONCLUSIONS
  The cost of care in patients with gabapentin-refractory peripheral neuropathic pain appeared to be significantly reduced after switching to pregabalin treatment, alone or in combination with other analgesic drugs, in a real-life setting.
authors: Primary Care Health Centre Puerta del Ángel, Madrid, Spain. navarrosiguero@eresmas.com
authors: Ana
authors: A
authors: Navarro
authors: María T
authors: MT
authors: Saldaña
authors: Concepción
authors: C
authors: Pérez
authors: Xavier
authors: X
authors: Masramón
authors: Javier
authors: J
authors: Rejas
mesh_terms: D000328:Adult; D000368:Aged; D000588:Amines / Q000191:economics* / Q000627:therapeutic use; D000700:Analgesics / Q000191:economics* / Q000627:therapeutic use; D003509:Cyclohexanecarboxylic Acids / Q000191:economics* / Q000627:therapeutic use; D005260:Female; D000077206:Gabapentin; D017048:Health Care Costs / Q000639:trends*; D006295:Health Resources / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000188:drug therapy* / Q000191:economics* / Q000453:epidemiology; D000069583:Pregabalin; D013030:Spain / Q000453:epidemiology; D005680:gamma-Aminobutyric Acid / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use
chemical_list: D000588:Amines; D000700:Analgesics; D003509:Cyclohexanecarboxylic Acids; D000069583:Pregabalin; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin