PREGABALIN IS ASSOCIATED WITH LOWER HEALTH CARE COSTS AND LESS ABSENTEEISM THAN GABAPENTIN WHEN ADDED TO THE TREATMENT OF NEUROPATHIC PAIN

To compare the costs of adding pregabalin or gabapentin to existing therapy in patients with peripheral neuropathic pain (PNeP) in routine medical practice in a Spanish setting. A retrospective database analysis was performed using patients' medical claims records. Medical records from male and female patients, with PNeP, >18 years, in whom pregabalin, or gabapentin was initiated between 2006 and 2008 were included in the analysis. The economic model included health care resource utilization and corresponding costs, from a third-payer perspective. Estimates of indirect costs, due to sick leave were included. A total of 1160 records were eligible for analysis: 764 (65.7%) treated with pregabalin and 399 (34.3%) gabapentin. Patients in both groups were comparable. No significant differences were observed for previous average number of analgesics: pregabalin 2.7 (0.1); gabapentin 2.8 (0.1), p=0.362. However, concomitant use of analgesics was higher in gabapentin cohort; 3.2 (0.1) versus 2.7 (0.1); p=0.003, mainly due to a higher utilization of NSAIDs (74.9% versus 69.5%; p=0.018) and opioids (27.7% vs. 17.9%; p=0.031). Adjusted mean (95% CI) total costs per patient were significantly lower in pregabalin group; €2514 (2228-2800) versus €3241 (2853-3630); p= 0.003, due to minor labour productivity losses; €1067 (790-1345) versus €1633 (1256-2009); p=0.018, and lower adjusted health care costs; €1447 (1380-1513) versus €1609 (1519-1698); p=0.004. The higher drug acquisition costs for pregabalin [€351 versus €191; p<0.001) was compensated for by lower overall health care costs, mainly in medical visits, physiotherapy, hospitalization days and concomitant analgesics. In a population setting in Spain, pregabalin treated patients with PNeP were considerable less costly for the healthcare provider than those treated with gabapentin in routine clinical practice. The higher acquisition cost of pregabalin was compensated largely by lower costs in the other components of health care costs. Patients treated with pregabalin had significantly less sick leaves than gabapentin treated patients.