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Costs and Health Resources Utilization Following Switching to Pregabalin in Individuals with Gabapentin‐Refractory Neuropathic Pain: A post hoc Analysis
Author(s) -
Navarro Ana,
Saldaña María T.,
Pérez Concepción,
Masramón Xavier,
Rejas Javier
Publication year - 2012
Publication title -
pain practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 58
eISSN - 1533-2500
pISSN - 1530-7085
DOI - 10.1111/j.1533-2500.2011.00515.x
Subject(s) - pregabalin , medicine , gabapentin , neuropathic pain , refractory (planetary science) , post hoc analysis , visual analogue scale , anesthesia , physical therapy , alternative medicine , pathology , astrobiology , physics
Abstract Purpose: 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. Patients and 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.