Economic evaluation of duloxetine as a first-line treatment for painful diabetic peripheral neuropathy in Mexico

• DOI: 10.3111/13696998.2011.640730
• Publication Date: 2011-11-28T16:33:51Z
• Authors: Fernando Carlos; Jocelyn Ramírez-G...; Héctor Dueñas; Rosa María Galind...; Elisa Ramos
• Keywords: Diabetic Neuropathy

To perform an economic evaluation of duloxetine, pregabalin, and both branded generic gabapentin for managing pain in patients with painful diabetic peripheral neuropathy (PDPN) Mexico.The analysis was conducted using a 3-month decision model, which compares duloxetine 60 mg once daily (DUL), pregabalin 150 twice (PGB), 600 three-times (GBP) PDPN moderate-to-severe pain. A systematic review performed placebo-adjusted risk ratios achieving good relief (GPR), adverse events (AE), withdrawal owing to intolerable AE were calculated. Direct medical costs included drug acquisition additional visits due lack efficacy (poor relief) or AE. Unit taken from local sources. Adherence rates used estimate the expected costs. All are expressed 2010 Mexican Pesos (MXN). Utility values drawn published literature applied health states. The proportion GPR quality-adjusted life years (QALY) assessed.Branded-GBP dominated by all other options. PGB more costly less effective than DUL. Compared branded-GBP PGB, DUL led savings 1.01 1.74 million MXN (per 1000 patients). incremental cost per QALY gained instead generic-GBP $102 433 MXN. This amount is slightly lower estimated gross domestic product capita Mexico 2010. During second-order Monte Carlo simulation, had highest probability being cost-effective (61%), followed (25%) (14%).Study limitations include short timeframe data different dosage schemes GBP PGB.This study suggests that provides overall better outcomes compared PGB. Administering rather intervention manage Mexico.