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Instituto Nacional de Neurología y Neurocirugía

2013, Number 4

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Arch Neurocien 2013; 18 (4)

Economic evaluation of duloxetine in the treatment of chronic low back pain in Mexico

Rivera FC, Ramírez GJ, Ruiz I

Language: English
References: 65
Page: 171-180
PDF size: 821.96 Kb.


ABSTRACT

Objective: to compare the costs and efficacy results of duloxetine 60 mg QD/BID (DUL) and the fixed combination of tramadol/paracetamol 37.5/325 mg every 4 to 6 hours (TMD/PCM) in the pharmacological treatment of chronic low back pain (CLBP) from the perspective of public and private healthcare systems in Mexico. Material and methods: we performed a systematic search of all the multicenter, double-blind, randomized and placebo-controlled studies evaluating DUL and TMD/PCM in CLBP. By using the adjusted indirect comparison, we determined the likelihood of achieving satisfactory response (defined as pain relief ≥30 and ≥50% -compared to baseline) and early withdrawal. The time horizon of the study was 3 months. All the drugs acquisition costs, intolerable adverse event attention costs and medical management according to response type, were analyzed and expressed in Mexican pesos. Information sources included official listings and published literature. The sensitivity analysis was deterministic and probabilistic. Results: for both perspectives public and private, DUL resulted to be a dominant option (less costly, more effective) than TMD/PCM. Mean savings in patient receiving DUL were $203 pesos (1.5%) and $1,545 pesos (8.6%) for public and private perspectives, respectively. This means that for every 10,000 patients treated with DUL there would be a gain of 3 quality-adjusted life years (QALY). The model remains robust and DUL was the preferred choice in 59% (public perspective) and 90% (private perspective) of the generated simulations. Conclusion: DUL offer important savings in the management of LBP and represents a more-convenient regimen for patients.


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