Pregabalin Vs Gabapentin Cost-Effectiveness for Peripheral Neuropathic Pain and Postherpetic Neuralgia
Peripheral neuropathic pain (pNeP) is a general pain disorder caused by a lesion or disease of the peripheral somatosensory nervous system and occurs frequently with diabetes or following herpes zoster reactivation. Symptoms of pNep may include numbness, tingling, weakness and burning and may lead to more severe events such as higher blood pressure, vomiting and diarrhea.
It has been reported that China's rapidly aging population portends a coming transition from acute illness as its primary health challenge to chronic diseases which takes long time for the treatment. Several drugs like pregabalin; gabapentin was administered to the patients which were effective. However to compare the cost-effectiveness of pregabalin was compared with the gabapentin in pNeP and PHN.
A 12 week simulation model was developed to determine the cost-effectiveness of pregabalin compared to gabapentin. 1000 patients with pNeP and PHN were included in the trial for the comparison. A questionnaire of Chinese key opinion leaders was utilized to estimate the pre-treatment distribution of pain scores for pNeP and PHN. The treatment outcomes for pregabalin and gabapentin were acquired from the published literature.
During analysis, treatment with pregabalin lead to decrease in pain scores of 0.6 (pNeP) and 0.7 (PHN) after 12 week when compared to patients receiving gabapentin at an incremental cost per additional day of mild/no pain of $45. The difference in mean days of no or mild pain, moderate pain and severe pain observed were 8.8, -5.7 and -3.1 between pregabalin and gabapentin. Pregabalin showed more mean days with a reduction of >30% (7.71 days), 40% (8.97 days), and 50% in pain. When compared with gabapentin. In the pNeP scenario, pregabalin was associated with a lower average pain score as compared with gabapentin (3.91 vs. 4.55). The difference in mean days of no or mild pain, moderate pain and severe pain was 9.39, -5.56 and -3.82 after comparison between pregabalin and gabapentin. Pregabalin showed more mean days with a >30% (8.77 days), 40% (9.81 days), and 50% reduction (10.55 days) in pain when compared with gabapentin.
After the completion of analysis, it was declared that pregabalin is an effective treatment for post herpetic neuralgia and even for peripheral neuropathic pain but with an increase in cost which lead to improved outcomes including lower pain scores and more days with no or mild pain.