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Adding Pregabalin or Gabapentin for the Management of Community-Treated Patients with Painful Diabetic Peripheral Neuropathy: A Comparative Cost Analysis

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Abstract

Background and Objective

Painful diabetic peripheral neuropathy (pDPN) is a highly prevalent complication of diabetes mellitus, which is associated with substantial costs to society and national health systems. This economic impact varies depending on the therapeutic management provided to patients. The objective of this study was to compare healthcare resource utilization and costs among pDPN patients newly treated with pregabalin or gabapentin in routine medical practice.

Methods

We performed a retrospective medical records study of pDPN patients newly treated with pregabalin or gabapentin as an add-on therapy who are covered by the Badalona Serveis Assistencials (BSA) health plan, a healthcare provider in Spain, from 2006 to 2009. Healthcare resource utilization and days off work were assessed. The societal perspective was used to estimate costs.

Results

Three hundred and ninety-five records were eligible for analysis: 227 (57.5 %) included pregabalin and 168 (42.5 %) gabapentin. Mean (standard deviation) concomitant use of analgesics throughout the study was higher in the gabapentin cohort [3.9 (2.2) vs. 3.1 (2.1); p < 0.05], mainly due to greater use of non-narcotics (78.0 vs. 71.8 %; p < 0.05) and opioids (32.7 vs. 28.6 %; p < 0.05). Healthcare costs accounted for 59.2 % of total costs, of which 71.9 % occurred in primary care, with a mean cost per patient of €2,476 (year 2010 values). Adjusted mean (95 % CI) total costs were significantly lower in pregabalin-treated patients [€2,003 (1,427–2,579)] than in gabapentin-treated patients [€3,127 (2,463–3,790)] (p = 0.013), mainly due to lower healthcare costs [€1,312 (1,192–1,432) vs. €1,675 (1,537–1,814); p < 0.001].

Conclusions

Adding pregabalin to existing pDPN therapy resulted in lower total healthcare costs and lower resource utilization than resulted from adding gabapentin.

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Acknowledgments

We thank the Badalona Serveis Assistencials (BSA) healthcare professionals who aided this study. BSA healthcare professionals were not paid for the development of this manuscript. This study was funded by Pfizer Inc. Javier Rejas is a full employee of Pfizer, S.L.U. Dr. Antoni Sicras is an employee of DataClinics who was a paid consultant to Pfizer for the statistical analysis and for the development of this manuscript. All other authors declare that they have no competing interests. All authors had complete access to the data, participated in the analysis and/or interpretation of results, drafted and approved the content of the manuscript. Antoni Sicras and Javier Rejas participated in the design and idea of the original study and in the interpretation of data and drafting the manuscript. Albert Planas and Ruth Navarro participated in data interpretation, review of the manuscript, and made an important contribution to several parts of the manuscript. All authors were responsible for literature review and extraction of references.

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Authors and Affiliations

  1. Dirección de Planificación y Desarrollo Organizativo, Badalona Serveis Assistencials SA, Gaietà Soler, 6-8 entlo, 08911, Badalona, Barcelona, Spain

    Antoni Sicras

  2. Health Economics and Outcomes Research Department, Pfizer, S.L.U., Alcobendas, Madrid, Spain

    Javier Rejas

  3. Department of Clinical Documentation, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain

    Ruth Navarro

  4. Department of Neurology, Hospital Municipal de Badalona, Badalona, Barcelona, Spain

    Albert Planas

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  1. Antoni Sicras
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  4. Albert Planas
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Correspondence to Javier Rejas.

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Sicras, A., Rejas, J., Navarro, R. et al. Adding Pregabalin or Gabapentin for the Management of Community-Treated Patients with Painful Diabetic Peripheral Neuropathy: A Comparative Cost Analysis. Clin Drug Investig 33, 825–835 (2013). https://doi.org/10.1007/s40261-013-0131-8

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