title: [Capsaicin Cutaneous Patch: a Cost-consequences Study in a French University Hospital].
abstract: BACKGROUND
  The capsaïcine 8% cutaneous patch (Qutenza®) was recently approved for the management of patients with peripheral neuropathic pain (PNP). Considering its limited clinical efficacy data, its improvement of medical benefit was determined to be 5 which was insufficient to support its reimbursement in addition to diagnosis related groups'tarifs. Nevertheless its commercialization was associated with a marked interest considering the unmet therapeutic needs for patients with PNP.
  
  
  OBJECTIVE
  Our objectives were to assess the effectiveness, the safety, and the economic impact of Qutenza® in real-life conditions.
  
  
  METHODS
  An observational cost-consequences study was launched under the aegis of the Drug Committee of our hospital. Medical charts and prescriptions of all patients who received at least one patch application were analyzed. Effectiveness and safety were assessed after 12-week and 24-week of follow-up. The economic impact was measured within the Hospital and Health Insurance perspective and with limitation to direct costs.
  
  
  RESULTS
  From March 2012 to October 2013, 91 patients (54.3 ± 14.1 years; 52.7% of male) received at least one application. The average follow- up duration was 188.3 ± 86.4 days. The PNP etiologies were mainly post-surgery (42.9%) and post-traumatology (20.8%). A therapeutic response (decrease of ENS score of least 30%) after 12 weeks and 24 weeks was observed in 27.9% and 37.1% of patients respectively. The SF-36 mental score was significantly improved. The safety profile was good. The application of the patch resulted in incremental costs of 154 euros per hospital stay without impact on outpatient-prescription drug expenditures.
  
  
  CONCLUSIONS
  This study confirms the interest of Qutenza® for heavily pretreated, refractory patients with PNP. The clinical profile of responders has to be further investigated in large observational studies.
authors.affiliation: Hospices Civils de Lyon, Groupement Hospitalier Est, Service Pharmaceutique, Lyon, France.
authors.forename: Maud
authors.initials: M
authors.lastname: Schweitzer
authors.affiliation: Hospices Civils de Lyon, Groupement Hospitalier Est, Centre d'Évaluation et de Traitement de la Douleur, Lyon, France.
authors.forename: Jean-Bernard
authors.initials: JB
authors.lastname: Caillet
authors.affiliation: Hospices Civils de Lyon, Hôpital Edouard Herriot, Service Pharmaceutique, Lyon, France - Hospices Civils de Lyon, Comité de Lutte contre la Douleur, Lyon, France.
authors.forename: Carole
authors.initials: C
authors.lastname: Paillet
authors.affiliation: Hospices Civils de Lyon, Hôpital Edouard Herriot, Consultation et Traitement de la Douleur, Lyon, France.
authors.forename: Christian
authors.initials: C
authors.lastname: Baude
authors.affiliation: Centre Hospitalier Universitaire de Dijon, Service Pharmacie, Dijon, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Fagnoni
authors.affiliation: Hospices Civils de Lyon, Groupement Hospitalier Est, Service Pharmaceutique, Lyon, France.
authors.forename: Gilles
authors.initials: G
authors.lastname: Aulagner
authors.affiliation: Hospices Civils de Lyon, Délégation à la Recherche Clinique et à l'Innovation, Cellule Innovation/UMR-CNRS 5510/MATEIS, Lyon, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Armoiry
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D000368:Aged; D002211:Capsaicin / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D003362:Cost-Benefit Analysis; D005260:Female; D005602:France / Q000453:epidemiology; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000188:drug therapy / Q000453:epidemiology; D010523:Peripheral Nervous System Diseases / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology; D057968:Transdermal Patch / Q000009:adverse effects / Q000191:economics
chemical_list: D002211:Capsaicin