Back to Journals » ClinicoEconomics and Outcomes Research » Volume 7

Cost-effectiveness analysis of pregabalin for treatment of chronic low back pain in patients with accompanying lower limb pain (neuropathic component) in Japan

Authors Igarashi A, Akazawa M, Murata T, Taguchi T, Sadosky A, Ebata N, Willke R, Fujii K, Doherty J, Kobayashi M

Received 4 June 2015

Accepted for publication 17 August 2015

Published 7 October 2015 Volume 2015:7 Pages 505—520

DOI https://doi.org/10.2147/CEOR.S89833

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Qian Ding

Peer reviewer comments 4

Editor who approved publication: Dr Giorgio Colombo

Ataru Igarashi,1 Manabu Akazawa,2 Tatsunori Murata,3 Toshihiko Taguchi,4 Alesia Sadosky,5 Nozomi Ebata,6 Richard Willke,5 Koichi Fujii,6 Jim Doherty,5 Makoto Kobayashi3

1Department of Drug Policy and Management, Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo, Japan; 2Department of Public Health and Epidemiology, Meiji Pharmaceutical University, Tokyo, Japan; 3CRECON Medical Assessment Inc., Tokyo, Japan; 4Department of Orthopaedic Surgery, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan; 5Pfizer Inc., New York, NY, USA; 6Pfizer Japan, Inc., Tokyo, Japan

Objective: To assess the cost-effectiveness of pregabalin for the treatment of chronic low back pain with accompanying neuropathic pain (CLBP-NeP) from the health care payer and societal perspectives.
Methods: The cost-effectiveness of pregabalin versus usual care for treatment of CLBP-NeP was evaluated over a 12-month time horizon using the incremental cost-effectiveness ratio (ICER). Quality-adjusted life years (QALYs), derived from the five-dimension, five-level EuroQol (EQ-5D-5L) questionnaire, was the measure of effectiveness. Medical costs and productivity losses were both calculated. Expected costs and outcomes were estimated via cohort simulation using a state-transition model, which mimics pain state transitions among mild, moderate, and severe pain. Distributions of pain severity were obtained from an 8-week noninterventional study. Health care resource consumption for estimation of direct medical costs for pain severity levels was derived from a physician survey. The ICER per additional QALY gained was calculated and sensitivity analyses were performed to evaluate the robustness of the assumptions across a range of values.
Results: Direct medical costs and hospitalization costs were both lower in the pregabalin arm compared with usual care. The estimated ICERs in the base case scenarios were approximately ¥2,025,000 and ¥1,435,000 per QALY gained with pregabalin from the payer and societal perspectives, respectively; the latter included indirect costs related to lost productivity. Sensitivity analyses using alternate values for postsurgical pain scores (0 and 5), initial pain severity levels (either all moderate or all severe), and the actual EQ-5D-5L scores from the noninterventional study showed robustness of results, with ICERs that were similar to the base case. Development of a cost-effectiveness acceptability curve showed high probability (≥75%) of pregabalin being cost-effective.
Conclusion: Using data and assumptions from routine clinical practice, pregabalin is cost-effective for the treatment of CLBP-NeP in Japan.

Keywords: usual care, neuropathic pain, Markov model, quality-adjusted life-year, willingness to pay, health economics

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]

 

Other articles by this author:

Characterizing individual painDETECT symptoms by average pain severity

Sadosky A, Koduru V, Bienen EJ, Cappelleri JC

ClinicoEconomics and Outcomes Research 2016, 8:361-366

Published Date: 26 July 2016

Characterizing neuropathic pain profiles: enriching interpretation of painDETECT

Cappelleri JC, Koduru V, Bienen EJ, Sadosky A

Patient Related Outcome Measures 2016, 7:93-99

Published Date: 5 July 2016

Effectiveness of pregabalin for the treatment of chronic low back pain with accompanying lower limb pain (neuropathic component): a non-interventional study in Japan

Taguchi T, Igarashi A, Watt S, Parsons B, Sadosky A, Nozawa K, Hayakawa K, Yoshiyama T, Ebata N, Fujii K

Journal of Pain Research 2015, 8:487-497

Published Date: 5 August 2015

A cross-sectional study examining the psychometric properties of the painDETECT measure in neuropathic pain

Cappelleri JC, Koduru V, Bienen EJ, Sadosky A

Journal of Pain Research 2015, 8:159-167

Published Date: 15 April 2015

Measurement properties of painDETECT by average pain severity

Cappelleri JC, Bienen EJ, Koduru V, Sadosky A

ClinicoEconomics and Outcomes Research 2014, 6:497-504

Published Date: 6 November 2014

Pain severity and the economic burden of neuropathic pain in the United States: BEAT Neuropathic Pain Observational Study

Schaefer C, Sadosky A, Mann R, Daniel S, Parsons B, Tuchman M, Anschel A, Stacey BR, Nalamachu S, Nieshoff E

ClinicoEconomics and Outcomes Research 2014, 6:483-496

Published Date: 29 October 2014

Economic and humanistic burden of post-trauma and post-surgical neuropathic pain among adults in the United States

Parsons B, Schaefer C, Mann R, Sadosky A, Daniel S, Nalamachu S, Stacey BR, Nieshoff EC, Tuchman M, Anschel A

Journal of Pain Research 2013, 6:459-469

Published Date: 17 June 2013

Impact of reducing dosing frequency on adherence to oral therapies: a literature review and meta-analysis

Srivastava K, Arora A, Kataria A, Cappelleri JC, Sadosky A, Peterson AM

Patient Preference and Adherence 2013, 7:419-434

Published Date: 20 May 2013

Burden of illness associated with painful diabetic peripheral neuropathy among adults seeking treatment in the US: results from a retrospective chart review and cross-sectional survey

Sadosky A, Schaefer C, Mann R, Bergstrom F, Baik R, Parsons B, Nalamachu S, Nieshoff E, Stacey BR, Anschel A, Tuchman M

Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy 2013, 6:79-92

Published Date: 8 February 2013

Association of patient-rated severity with other outcomes in patients with painful diabetic peripheral neuropathy

Taylor-Stokes G, Pike J, Sadosky A, Chandran A, Toelle T

Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy 2011, 4:401-408

Published Date: 5 December 2011

Readers of this article also read:

Green synthesis of water-soluble nontoxic polymeric nanocomposites containing silver nanoparticles

Prozorova GF, Pozdnyakov AS, Kuznetsova NP, Korzhova SA, Emel’yanov AI, Ermakova TG, Fadeeva TV, Sosedova LM

International Journal of Nanomedicine 2014, 9:1883-1889

Published Date: 16 April 2014

Methacrylic-based nanogels for the pH-sensitive delivery of 5-Fluorouracil in the colon

Ashwanikumar N, Kumar NA, Nair SA, Kumar GS

International Journal of Nanomedicine 2012, 7:5769-5779

Published Date: 15 November 2012

A novel preparation method for silicone oil nanoemulsions and its application for coating hair with silicone

Hu Z, Liao M, Chen Y, Cai Y, Meng L, Liu Y, Lv N, Liu Z, Yuan W

International Journal of Nanomedicine 2012, 7:5719-5724

Published Date: 12 November 2012

Cross-linked acrylic hydrogel for the controlled delivery of hydrophobic drugs in cancer therapy

Deepa G, Thulasidasan AK, Anto RJ, Pillai JJ, Kumar GS

International Journal of Nanomedicine 2012, 7:4077-4088

Published Date: 27 July 2012

Crystallization after intravitreal ganciclovir injection

Pitipol Choopong, Nattaporn Tesavibul, Nattawut Rodanant

Clinical Ophthalmology 2010, 4:709-711

Published Date: 14 July 2010