Darbà Josep, Kaskens Lisette, Pérez Concepción, Álvarez Enrique, Navarro-Artieda Ruth, Sicras-Mainar Antoni
Department of Economics, Universidad de Barcelona, Barcelona, Spain,
Adv Ther. 2014 Jan;31(1):1-29. doi: 10.1007/s12325-013-0088-2. Epub 2014 Jan 4.
Pregabalin is an anticonvulsant approved in Europe for the treatment of neuropathic pain, as an adjunct therapy for epileptic seizures, and recently for generalized anxiety disorder. The aim of this study was to conduct a systematic review to evaluate the cost-effectiveness of pregabalin associated with the treatment of its labeled indications from a societal perspective in Spain.
Data from the MEDLINE database were searched using algorithms to identify relevant economic evaluations published in English or Spanish on pregabalin for the management of neuropathic pain, generalized anxiety disorder (GAD), and epilepsy in Spanish patients over the last 10 years.
In total, 52 potentially relevant abstracts were identified from the MEDLINE database. Twenty manuscripts met the inclusion criteria. The majority of the selected papers (14/20) evaluated pregabalin for neuropathic pain from a societal perspective in Spain (5 economic models of pregabalin vs. gabapentin, 4 economic analyses of pregabalin in comparison with usual care, 4 economic evaluations comparing pregabalin monotherapy with add-on strategies, and one that evaluated different times of initiating pregabalin therapy). Five studies analyzed the use of pregabalin in Spain for the management of GAD (one cost-effectiveness model that compared pregabalin with venlafaxine, 2 secondary analyses in benzodiazepine-refractory patients, and 2 studies evaluating pregabalin vs. usual care in patients refractory to standard regimens). The last manuscript described a cost-effectiveness model that compared pregabalin versus levetiracetam use for the treatment of refractory partial epilepsy.
The majority of published evidence supports the possibility that pregabalin could be a cost-effective and/or cost-saving alternative for the treatment of refractory epilepsy, GAD, and neuropathic pain, in both treatment-naïve patients and in those who have demonstrated inadequate response or intolerance to previous therapy.
普瑞巴林是一种抗惊厥药物，在欧洲被批准用于治疗神经性疼痛、作为癫痫发作的辅助治疗药物，最近还被批准用于治疗广泛性焦虑症。本研究的目的是进行一项系统评价，从西班牙社会角度评估普瑞巴林与其标签适应证治疗相关的成本效益。
使用算法检索MEDLINE数据库中的数据，以识别过去10年中以英文或西班牙文发表的关于普瑞巴林用于西班牙患者治疗神经性疼痛、广泛性焦虑症（GAD）和癫痫的相关经济评估。
从MEDLINE数据库中总共识别出52篇潜在相关摘要。20篇手稿符合纳入标准。大多数入选论文（14/20）从西班牙社会角度评估了普瑞巴林治疗神经性疼痛（5个普瑞巴林与加巴喷丁的经济学模型、4个普瑞巴林与常规治疗比较的经济分析、4个比较普瑞巴林单药治疗与联合治疗策略的经济评估，以及1个评估普瑞巴林治疗起始不同时间的研究）。5项研究分析了普瑞巴林在西班牙用于治疗GAD的情况（1个比较普瑞巴林与文拉法辛的成本效益模型、2项在苯二氮䓬类药物难治性患者中的二次分析，以及2项评估普瑞巴林与标准方案难治性患者常规治疗比较的研究）。最后一篇手稿描述了一个比较普瑞巴林与左乙拉西坦用于治疗难治性部分性癫痫的成本效益模型。
大多数已发表的证据支持普瑞巴林可能是治疗难治性癫痫、GAD和神经性疼痛的具有成本效益和/或节省成本的替代方案，无论是初治患者还是对先前治疗反应不足或不耐受的患者。
