title: Cost savings associated with early initiation of pregabalin in the management of peripheral neuropathic pain.
abstract: OBJECTIVE
  Peripheral neuropathic pain (PNP) is associated with significant economic burden. Guidelines recommend the early adoption of appropriate pharmacological interventions. The aim of this study was to explore whether early initiation of pregabalin was associated with lower economic burden, than later initiation, in the management of refractory chronic PNP.
  
  
  METHODS
  A secondary analysis of a multicenter, observational cost-of-illness study was carried out in adults older than 18 years of age with refractory chronic PNP. Patients were pregabalin naive, with a poor response to previous analgesic therapy, defined as pain >40 in a 0 to 100 mm visual analog scale after, at least, 1 analgesic. The total costs, health care and indirect, assessed 12 weeks before the initiation of pregabalin were analyzed according to the time elapsed since diagnosis.
  
  
  RESULTS
  One thousand one hundred thirty-nine outpatients, 59.3 (12.8) years old, 59.3% women, 2.0 (3.5) years with a diagnosis of PNP, fulfilled the criteria for analysis. Adjusted (pain intensity, sex, age, and body mass index) mean total costs 12 weeks before the baseline visit were significantly lower when pregabalin was initiated early (<6 mo; n=389) in comparison with later initiation; 6 to 12 months (n=328), or >12 months (n=422) after diagnosis; €2439 (2197; 2681) versus €3011 (2758; 3264) and €2945 (2717; 3173), respectively (P<0.01 in both cases). Lower health care costs and fewer lost-workday equivalents with early initiation of pregabalin were the main factors contributing to these findings.
  
  
  CONCLUSIONS
  Early initiation of pregabalin treatment after diagnosis in patients with refractory chronic PNP may result in substantial cost savings from a societal perspective in daily practice in Spain.
authors: Pain Clinic, Hospital Universitario La Princesa, Madrid, Spain. cperez.hlpr@salud.madrid.org
authors: Concepción
authors: C
authors: Pérez
authors: Ana
authors: A
authors: Navarro
authors: María T
authors: MT
authors: Saldaña
authors: Marta
authors: M
authors: Figueras-Balsells
authors: Marta
authors: M
authors: Muñoz-Tudurí
authors: Javier
authors: J
authors: Rejas
mesh_terms: D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000191:economics / Q000706:statistics & numerical data; D000700:Analgesics / Q000191:economics / Q000627:therapeutic use*; D017046:Cost Savings / Q000191:economics* / Q000379:methods; D003362:Cost-Benefit Analysis; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000188:drug therapy* / Q000191:economics* / Q000523:psychology; D010147:Pain Measurement; D010342:Patient Acceptance of Health Care; D000069583:Pregabalin; D012189:Retrospective Studies; D013997:Time Factors; D016526:Workload; D055815:Young Adult; D005680:gamma-Aminobutyric Acid / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use
chemical_list: D000700:Analgesics; D000069583:Pregabalin; D005680:gamma-Aminobutyric Acid