Cost effectiveness of duloxetine in the treatment of diabetic peripheral neuropathic pain in the UK

Stephen M. Beard, L. McCrink, T. K. Le, A. Garcia-Cebrian, B. Monz, Rayaz Malik

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21 Citations (Scopus)

Abstract

Objective: The objective of this analysis was to evaluate the cost-effectiveness of duloxetine when considered as an additional treatment option for UK-based patients suffering from diabetic peripheral neuropathic pain. Research design and methods: A decision-analytic model was used to represent the sequential management of patients with diabetic peripheral neuropathic pain. The standard UK treatment strategy was defined as first-line tricyclic antidepressants (amitriptyline), second-line anticonvulsants (gabapentin) and lastly an opioid-related treatment. The cost-effectiveness of duloxetine was evaluated as an additional first, second, third or fourth-line therapy over a 6-month treatment period for a cohort of 1000 patients. Treatment response was modelled based on changes from baseline pain severity using a standard 11-point pain scale (0-10); full response (≥ 50% change), partial response (30-49%) and no response (< 30%). The model was populated with efficacy and discontinuation data using indirect comparisons of treatment efficacy based on relative effects to a common placebo comparator. Results: The second-line use of duloxetine resulted in cost savings of £77071 for every 1000 treated patients, with an additional 29 patients achieving a full pain response when compared to standard UK treatment. Additional quality-adjusted life years (QALYs) were achieved at 1.88 QALYs per 1000 patients. Conclusions: This UK-based economic model suggests that second-line use of duloxetine is a beneficial and cost-effective treatment strategy for diabetic peripheral neuropathic pain.

Original languageEnglish
Pages (from-to)385-399
Number of pages15
JournalCurrent Medical Research and Opinion
Volume24
Issue number2
DOIs
Publication statusPublished - Feb 2008
Externally publishedYes

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Keywords

  • Cost-effectiveness
  • Diabetes
  • Duloxetine
  • Economic evaluation
  • Neuropathic pain

ASJC Scopus subject areas

  • Medicine(all)

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