A cost-effectiveness comparison of desipramine, gabapentin, and pregabalin for treating postherpetic neuralgia.
A cost-effectiveness comparison of desipramine, gabapentin, and pregabalin for treating postherpetic neuralgia.
复制标题
地昔帕明、加巴喷丁和普瑞巴林治疗带状疱疹后神经痛的成本效益比较。
DOI：
10.1111/j.1532-5415.2007.01246.x
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发表时间：
2007
影响因子：
6.3
通讯作者：
Holloway,RobertG
中科院分区：
文献类型：
--
作者：
O'Connor,AlecB;Noyes,Katia;Holloway,RobertG
目的：比较不同的一线带状疱疹后神经痛（PHN）药物治疗的净健康效应和成本。设计：使用已发表文献进行成本效用分析。参与者：年龄在60至80岁的PHN患者的假设队列。干预：地昔帕明100 mg/d，加巴喷丁1，800 mg/d，普瑞巴林450 mg/d。测量：设计一个决策模型来描述可能的治疗结果，包括不同的镇痛和副作用组合，在治疗中重度PHN的前3个月。 主要结局是获得的每质量调整生命年（QALY）成本。成本是从第三方支付者的角度估算的。进行多变量，单变量和概率敏感性分析，模型的时间范围变化为1个月和6个月的horizontes.RESULTS：地昔帕明是更有效，更便宜的加巴喷丁或普瑞巴林（占主导地位）在所有测试条件下。加巴喷丁比普瑞巴林更有效，但增量成本为216，000美元/QALY。低于140美元/月，加巴喷丁变得更具成本效益比普瑞巴林在阈值为50，000美元/QALY，低于115美元/月加巴喷丁为主pregabalin.CONCLUSION：地昔帕明似乎是更有效的，更便宜的治疗老年患者与加巴喷丁或普瑞巴林与PHN中，它不是禁忌。价格福尔斯下跌后，仿制药加巴喷丁可能比普瑞巴林更具成本效益。
OBJECTIVES:To compare the net health effects and costs resulting from treatment with different first‐line postherpetic neuralgia (PHN) medications.DESIGN:Cost–utility analysis using published literature.PARTICIPANTS:Hypothetical cohort of patients aged 60 to 80 with PHN.INTERVENTIONS:Desipramine 100 mg/d, gabapentin 1,800 mg/d, and pregabalin 450 mg/d.MEASUREMENTS:A decision model was designed to describe possible treatment outcomes, including different combinations of analgesia and side effects, during the first 3 months of therapy for moderate to severe PHN. The main outcome was cost per quality‐adjusted life‐year (QALY) gained. Costs were estimated using the perspective of a third‐party payer. Multivariate, univariate, and probabilistic sensitivity analyses were performed, and the time frame of the model was varied to 1‐month and 6‐month horizons.RESULTS:Desipramine was more effective and less expensive than gabapentin or pregabalin (dominant) under all conditions tested. Gabapentin was more effective than pregabalin but at an incremental cost of $216,000/QALY. Below $140/month, gabapentin became more cost‐effective than pregabalin at a threshold of $50,000/QALY, and below $115/month gabapentin dominated pregabalin.CONCLUSION:Desipramine appears to be more effective and less expensive than gabapentin or pregabalin for the treatment of older patients with PHN in whom it is not contraindicated. After its price falls, generic gabapentin will likely be more cost‐effective than pregabalin.