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Instituto Nacional de Neurología y Neurocirugía

2013, Number 3

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Arch Neurocien 2013; 18 (3)

Costo-efectividad del uso de duloxetina en el tratamiento farmacológico de fibromialgia en México

Rivera FC, Ramírez-Gámez J, Ruiz I, Ortiz-Escalante K

Language: Spanish
References: 66
Page: 126-137
PDF size: 161.47 Kb.


ABSTRACT

Objective: to compare the costs and health outcomes of duloxetine 60 mg QD (DUL60 mg), pregabalin 150mg BID (PGB300 mg) and pregabalin 225 mg BID (PGB450 mg) in the treatment of fibromyalgia (FM) from the perspective of public and private healthcare systems in Mexico. Methods: a systematic review of multicenter, double-blind, randomised and placebo-controlled clinical trials evaluating the competitive treatment strategies in adult patients with FM was performed. Probabilities of achieving satisfactory response (defined as an improvement ≥ 30% in pain relief from baseline) and early withdrawal were derived by conducting an indirect comparison. Time horizon was set at 3 months. Only direct medical costs comprising acquisition of study drugs and medical visits by category of response were analyzed and they are expressed in 2012 mexican pesos. Sources of information include official listings and published literature. Deterministic and probabilistic sensitivity analyses were undertaken. Results: DUL60mg demonstrated to be the dominant strategy (less cost and more effective) compared to PGB300 mg and PGB450 mg under both healthcare perspectives. The mean savings per patient with DUL60 mg were $93.10 and $1,825.76 (public perspective) and $383.61 and $4,936.63 (private perspective) compared to PGB300 mg and PGB450 mg, respectively. For every 1000/patients treated with DUL60 mg instead of PGB300 mg and PGB450 mg, 45 and 6 additional patients would achieve satisfactory response (527 vs. 482 vs. 521, respectively). DUL60mg was cost- saving in nearly 70% of the simulations. Conclusion: these results suggest DUL60 mg offers both savings in total costs and improvements in health outcomes compared to PGB300 mg and PGB450 mg for the treatment of FM in Mexico.


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