Cost of treatment of peripheral neuropathic pain with pregabalin or gabapentin in routine clinical practice: impact of their loss of exclusivity.
To analyze the effect of loss of exclusivity of data on the cost of treatment of peripheral neuropathic pain (PNP) with pregabalin or gabapentin in routine clinical practice. A retrospective observational study, with electronic medical records for patients enrolled at primary care centers managed by the health care provider Badalona Serveis Assistencials, who initiated treatment of PNP with pregabalin or gabapentin. The analysis used drugs and resources prices for year 2015. The 1163 electronic medical records (pregabalin; N = 764, gabapentin; N = 399) for patients (62.2% women) with a mean (standard deviation) age of 59.2 (14.7) years were analyzed. Treatment duration was slightly shorter with pregabalin than with gabapentin (5.2 vs 5.5 months; P = 0.124), with mean doses of 227.4 (178.6) mg and 900.0 (443.4) mg, respectively. The average study drug cost per patient was higher for pregabalin than for gabapentin; €214.6 (206.3) vs €157.4 (181.9), P < 0.001, although the cost of concomitant analgesic medication was lower; €176.5 (271.8) vs €306.7 (529.2), P < 0.001. The adjusted average total cost per patient was lower in those treated with pregabalin than in those treated with gabapentin; €2,413 (2119-2708) vs €3201 (2806-3.597); P = 0.002, owing to significantly lower health care costs; €1307 (1247-1367) vs €1538 (1458-1618), P < 0.001, and also non-health care costs; €1106 (819-1393) vs €1663 (1279-2048), P = 0.023, that was caused by a significantly lower use of concomitant medication, fewer medical visits to primary care, and fewer days of sick leave. After loss of exclusivity of both drugs, pregabalin continued to show lower health care and non-health care costs than gabapentin in the treatment of PNP in routine clinical practice.
Vicenç Papaciet Primary Care Centre (CAP), La Roca del Vallès, Barcelona, Spain.
Antoni
A
Sicras-Mainar
Health Economics and Outcomes Research Department, Pfizer SLU, Alcobendas, Madrid, Spain.
Javier
J
Rejas-Gutiérrez
Medical Department, Pfizer GEP SLU, Alcobendas, Madrid, Spain.
María
M
Pérez-Páramo
Medical Documentation Department, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain.
Ruth
R
Navarro-Artieda
D000328:Adult; D000368:Aged; D000588:Amines / Q000191:economics* / Q000627:therapeutic use; D000700:Analgesics / Q000191:economics* / Q000627:therapeutic use; D017507:Comoros; D003509:Cyclohexanecarboxylic Acids / Q000191:economics* / Q000627:therapeutic use; D057286:Electronic Health Records / Q000706:statistics & numerical data; D005260:Female; D000077206:Gabapentin; D005102:Health Expenditures / Q000706:statistics & numerical data; D006296:Health Services / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000188:drug therapy / Q000191:economics*; D000069583:Pregabalin / Q000191:economics* / Q000627:therapeutic use; D011320:Primary Health Care / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D013030:Spain; D005680:gamma-Aminobutyric Acid / Q000191:economics* / Q000627:therapeutic use
D000588:Amines; D000700:Analgesics; D003509:Cyclohexanecarboxylic Acids; D000069583:Pregabalin; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin
costs; gabapentin; loss of data exclusivity; neuropathic pain; pregabalin
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