OBJECTIVES

: To assess the cost-effectiveness of the lidocaine 5% medicated_plaster compared with pregabalin for the treatment of PHN and DNP from the Colombian General Social Security Health System (GSSHS) perspective.

METHODS

: Based on the results of a head-to-head trial [Baron_2009] comparing the lidocaine plaster and pregabalin in patients with PHN or DNP a Markov model [Dakin_2007] was constructed, from the perspective of the Columbian health care system (GSSHS). The model assesses the use of lidocaine_plaster monotherapy as first line treatment vs pregabalin over a 12-month time horizon.. The model estimates treatments costs and utilities according to the pain relief status and presence of adverse events (AE) through the initial 30-day run-in period and maintenance therapy. Patients without ≥30% reduction in NRS-3 scale added a second analgesic drug. If despite the combined scheme, patients were still without adequate pain relief or dropped out due to AE they switched to another analgesic option. 2020 Drug Price Information System was used for drug costs and the SOAT 2020 tariff catalog for procedures.

RESULTS

: The mean total therapy cost per patient with PHN or DPN treated with the lidocaine_plaster was USD$1,193, and USD$1,181 respectively compared with USD$1,195 and $936 for pregabalin. Treatment with the lidocaine_plaster was related to greater numbers of QALYs (0.895 in PHN and 0.898 in DPN) than with pregabalin (0.798 and 0.831 QALYs respectively). The lidocaine_plaster dominated pregabalin in the treatment of patients with PHN, being less costly and more effective. In DPN the lidocaine_plaster costs USD$3,673 per QALY gained relative to pregabalin. Probabilistic sensitivity analysis indicated that the findings are robust.

CONCLUSIONS

: According to our model calculation the 5% lidocaine medicated plaster is cost saving as first line treatment option in PHN and a highly cost-effective for the management of patients with DPN in Colombia compared with pregabalin form the Colombian GSSHS perspective.