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Pregabalin more cost-effective than gabapentin for treating patients with axial radiculopathy
Pregabalin therapy was considerably less costly than gabapentin for patients with painful axial radiculopathy in routine medical practice and resulted in patients taking significantly fewer sick days, according to study results.
Researchers in Spain conducted a retrospective analysis of medical records of 571 patients (mean age, 59.6 years; 62.9% women) with axial radiculopathy (RAD). The patients initiated therapy with pregabalin (n=378; 67.2% women) or gabapentin (n=193; 54.4% women) from 2006 to 2008. Health care resource utilization and costs from a third-payer perspective for a 1-year period after initiation were used for economic evaluation. Indirect costs attributed to lost work productivity also were calculated.
Dyslipidemia was observed in 47.6% of patients; 44.1% had hypertension and 35.6% displayed depressive syndrome. Lumbar RAD was experienced by 53.6% of patients; cervical RAD, 36.8%; and thoracic RAD, 9.6%.
Both therapies were comparable for time beyond diagnosis, treatment duration, prevalence of most comorbidities and previous use of analgesics.
The gabapentin cohort had a higher concomitant mean number of analgesics used compared with pregabalin-treated patients (3.1 vs. 2.8), which was primarily related to greater use of opioids (31.1% vs. 21.2%; P<.05) and non-narcotic drugs (63.7% vs. 52.1%; P<.01).
Adjusted mean annual costs were lower for pregabalin patients (€2.472; 95% CI, 2.101-2.836) than gabapentin patients (€3.346; 95% CI, 2.866-3.825; P=.005). Researchers attributed this difference to lower absenteeism (€1.012 [658-1.365] vs. €1.595 [1.129-2.062]; P=.042) and lower adjusted health care costs (€1.460 [1.360-1.560] vs. €1.750 [1.618-1.882]; P=.001) in the pregabalin group.
“The analysis … suggests that, in routine clinical practice in Spain, pregabalin may be more effective than gabapentin in reducing health care and nonhealth care resource utilization in patients with painful radiculopathy,” the researchers concluded. “In turn, these findings translated into less cost for the health payer, apparently because therapeutic doses of pregabalin were used more often than therapeutic doses of gabapentin.”
Disclosure: Researcher Javier Rejas-Gutiérrez is a full-time employee of Pfizer, SLU. The study was supported by Pfizer.