Assuntos
Unidades Hospitalares/organização & administração , Hospitais Universitários/organização & administração , Neurologia/organização & administração , Acidente Vascular Cerebral/terapia , Centros de Atenção Terciária/organização & administração , Morte Encefálica/diagnóstico por imagem , Procedimentos Endovasculares/estatística & dados numéricos , Unidades Hospitalares/estatística & dados numéricos , Hospitais Universitários/estatística & dados numéricos , Humanos , Internato e Residência , Corpo Clínico Hospitalar , Assistência Noturna/organização & administração , Equipe de Assistência ao Paciente , Seleção de Pacientes , Estudos Prospectivos , Sistema de Registros/estatística & dados numéricos , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/tratamento farmacológico , Acidente Vascular Cerebral/cirurgia , Centros de Atenção Terciária/estatística & dados numéricos , Trombectomia/estatística & dados numéricos , Terapia Trombolítica/estatística & dados numéricos , Tempo para o Tratamento , Obtenção de Tecidos e Órgãos/organização & administração , Ultrassonografia Doppler TranscranianaAssuntos
Síndrome de Guillain-Barré/diagnóstico , Criança , Doenças dos Nervos Cranianos/fisiopatologia , Transtornos de Deglutição/etiologia , Potenciais Somatossensoriais Evocados , Síndrome de Guillain-Barré/classificação , Síndrome de Guillain-Barré/etiologia , Síndrome de Guillain-Barré/terapia , Cefaleia/etiologia , Humanos , Imunoglobulinas Intravenosas/uso terapêutico , Perna (Membro)/inervação , Masculino , Cervicalgia/etiologia , Condução Nervosa , Parestesia/etiologia , Reflexo Anormal , Avaliação de Sintomas , Tonsilite/complicaçõesRESUMO
OBJECTIVE: To estimate the cost-effectiveness of pregabalin versus usual care (UC) in the management of community-treated patients with refractory painful diabetic peripheral neuropathy (pDPN) in primary care settings (PCS) in Spain. METHODS: Data was extracted from a 12-week registry study assessing costs of neuropathic pain in Spain. Pregabalin-naïve outpatients treated with UC or newly prescribed pregabalin were selected for inclusion in the cost-effectiveness analysis. Effectiveness was expressed as quality-adjusted life years (QALY) gain. Perspectives of the Spanish National Health System (NHS) and society (2006) were applied for cost calculations. Results were expressed as incremental cost-effectiveness ratio (ICER). Bootstrapping techniques (10,000 re-samples) were used to obtain the probabilistic ICER and the cost-effectiveness acceptability curve. RESULTS: A total of 189 patients were included in the economic analysis. Compared with UC, pregabalin was associated with higher QALY gain in a period of 12-weeks; 0.0406±0.0343 versus 0.0285±0.0350 (p=0.167). Overall total costs (1368±1229 vs. 1258±1474; p=0.587) and healthcare costs (628±590 vs. 469±420; p=0.134) were similar for both pregabalin and UC, respectively. ICERs for pregabalin varied from 5302 (95% CI: dominant; 144,105) for total costs to 14,381 (dominant; 115,648) for healthcare costs. Probabilistic sensitivity analyses showed that 79-84% of ICERs were below the threshold of 30,000/QALY. CONCLUSION: This study suggests that pregabalin may be cost-effective in the management of community-treated refractory outpatients, with pDPN when compared with usual care in the primary care setting in Spain. These findings may help policy makers when making health decision in the management of diabetes in the community.
