This uncertainty stems primarily from variability in utility values assigned to moderate and severe pain states, which was the prime contributor to the variance in the deterministic sensitivity analyses. Although duloxetine 120 mg represents the optimal choice, the substantial uncertainty suggests other treatments might offer a more favorable balance of costs and QALYs in nearly half of the plausible scenarios. This decision analytical model evaluates the cost-effectiveness of pregabalin, duloxetine, and milnacipran compared with amitriptyline in adults with moderate to severe fibromyalgia. Fourteen studies and 4,822 patients were included (2,650 in the pregabalin group, 432 in the benzodiazepine group, 792 in the SSRI/SNRI group, and 948 in the placebo group). Most of the studies (7 of 13, 53.8%) were published in the United States, and the follow-up period ranged from 4 to 52 weeks. The number of female participants, duration of symptoms, conflict of interests (COI), and funding are presented in Table 1.
- For the base-case analysis, it was assumed that patients who responded continued to do so for the remainder of the analysis.
- The cost of treatment with the capsaicin 8% patch was based on the average number of treatments in a 1-year period.
- Beta distributions were assigned to transition probabilities.69,70 Gamma distributions were selected for cost parameters to accommodate the right-skewed nature of cost data and variability across severity levels in FM.
Drugs Outcomes Research and Policies
High prescription costs can put added strain on individuals who are already dealing with the discomfort and limitations of chronic illnesses. According to GoodRx, the retail cost of Lyrica can exceed $600 for a typical supply, a price that’s often out of reach for many patients. Interestingly, our data show that doctors largely did not do as NHS England instructed. Most doctors prescribed some Lyrica, but prescribed less frequently than would be expected if they were using it for neuropathic pain. It is possible that some doctors did so deliberately, prescribing some Lyrica to avoid being detected as ‘non-compliant’, while avoiding substantial changes to their prescribing choices. There has also been a degree of bad feeling towards Pfizer from the medical community as a consequence of their actions.10 11 It will therefore be interesting to see whether the pharmaceutical industry undertakes similar action in the future.
Popular Prescriptions
The FDA requires generic drugs to have the same strength, purity, and quality as brand-name versions. The main difference is price—generic pregabalin typically costs much less. Learn more about generic versus brand-name drugs to understand why they’re equally effective. Beta distributions were assigned to transition probabilities.69,70 Gamma distributions were selected for cost parameters to accommodate the right-skewed nature of cost data and variability across severity levels in FM. All analyses were performed using Excel 2021 (Microsoft) and the hēRo3 (Avalere Health) web-based, open-source health economic modeling platform.74 All pregabalin price usa results are reported as expected mean per patient. Decision analytical model using a Markov cohort state transition model to estimate lifetime costs and quality-adjusted life-years (QALYs) for each investigated pharmacologic strategy.
