A Cost-Consequences Analysis of the Effect of Pregabalin in the Treatment of Painful Radiculopathy under Medical Practice Conditions in Primary Care Settings

Abstract

To analyze the effect of pregabalin (PGB) on pain relief, longitudinal utilization of health and nonhealth resources and derived costs in patients with refractory painful radiculopathy under routine medical practice in primary care settings (PCS). Subjects over 18 years of age with painful radiculopathy (cervical/lumbar) refractory to at least one previous analgesic therapy were included in a prospective, naturalistic, 12-week study. Consumption of resources included both health-care and nonhealth-care resources. Pain severity was measured using the Short Form of the McGill Pain Questionnaire. One thousand three hundred and four PGB-naive patients (55.8% women, 56.7 [12.9] years) were analyzed: 473 (36%) switched to monotherapy with PGB (PGBm), 676 (52%) received add-on therapy with PGB (PGBadd-on), and in 155 patients (12%) the previous treatment was replaced by a schedule not including PGB (non-PGB). As compared with the non-PGB, both PGBm and PGBadd-on schedules showed a significantly greater reduction of pain severity (36.1%, 56.1%, and 49.6% reductions, respectively, P < 0.001 between groups) and consumption of resources. Additional costs of drugs, particularly in the PGB subgroups (euro15.4, euro148.6 and euro145.3, respectively, P < 0.001) were offset by significantly greater reductions of all other components of health-care and nonhealth-care cost, thus resulting in a substantial reduction of total cost: euro1,203.3, euro1,423.2, and euro1,429.2, respectively (P < 0.001). In PCS, either PGBadd-on or PGBm under routine medical practice was associated with pain alleviation leading to significant longitudinal reductions in resource use and total costs compared with non-PGB-therapy in subjects with painful refractory cervical or lumbar radiculopathy.