Dirección de Planificación y Desarrollo Organizativo, Badalona Serveis Assistencials SA, Gaietà Soler, 6-8 entlo, 08911, Badalona, Barcelona, Spain,
Clin Drug Investig. 2013 Nov;33(11):825-35. doi: 10.1007/s40261-013-0131-8.
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.
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.
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].
Adding pregabalin to existing pDPN therapy resulted in lower total healthcare costs and lower resource utilization than resulted from adding gabapentin.
疼痛性糖尿病周围神经病变（pDPN）是糖尿病的一种常见并发症，给社会和国家卫生系统带来了巨大的经济负担。这种经济影响因患者接受的治疗管理而异。本研究的目的是比较在常规医疗实践中，新接受普瑞巴林或加巴喷丁作为附加治疗的 pDPN 患者的医疗资源利用和成本。
我们对 2006 年至 2009 年期间，西班牙医疗保健提供商 Badalona Serveis Assistencials（BSA）健康计划覆盖的新接受普瑞巴林或加巴喷丁作为附加治疗的 pDPN 患者进行了回顾性病历研究。评估了医疗资源的利用和旷工天数。采用社会视角来估计成本。
共有 395 份记录符合分析条件：227 份（57.5%）记录包含普瑞巴林，168 份（42.5%）记录包含加巴喷丁。整个研究过程中，加巴喷丁组患者（3.9 [2.2]）的镇痛药物合并使用比例高于普瑞巴林组（3.1 [2.1]）（p < 0.05），主要是因为非阿片类药物（78.0%对 71.8%；p < 0.05）和阿片类药物（32.7%对 28.6%；p < 0.05）的使用率较高。医疗保健费用占总费用的 59.2%，其中 71.9%发生在初级保健，每位患者的平均费用为 2476 欧元（2010 年的价值）。普瑞巴林治疗组的调整后平均（95%CI）总费用[2003 欧元（1427-2579 欧元）]显著低于加巴喷丁治疗组[3127 欧元（2463-3790 欧元）]（p = 0.013），主要是因为医疗保健费用较低[1312 欧元（1192-1432 欧元）对 1675 欧元（1537-1814 欧元）；p < 0.001]。
与加巴喷丁相比，在现有 pDPN 治疗中添加普瑞巴林可降低总医疗保健成本和资源利用率。
