Cost-Effectiveness of a High-Concentration (179 mg) Capsaicin Patch for the Treatment of Patients with Peripheral Neuropathic Pain in Scotland.

IF 3.3 2区医学 Q1 CLINICAL NEUROLOGY

Pain and Therapy Pub Date : 2025-10-01 Epub Date: 2025-08-31 DOI:10.1007/s40122-025-00769-9

Rita Freitas, Marjolijn van Keep, Prashanth Kandaswamy, Anja Prüfert, Miranda Ager, Marielle Eerdekens

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引用次数: 0

Abstract

Introduction: Peripheral neuropathic pain (PNP) is a chronic condition often inadequately controlled by oral pharmacologic treatments. High-concentration capsaicin patch (HCCP) is a topical neurolytic treatment for PNP. This study assessed the cost-effectiveness of HCCP as an add-on to standard of care (SoC) in patients with PNP in Scotland.

Methods: A cost-utility analysis was conducted using a Markov model with 3-month cycles and a lifetime horizon to determine the cost-effectiveness of HCCP added-on to SoC compared to SoC alone, in adult patients with PNP. The model included five health states (no pain, mild, moderate, severe pain, and death) and was developed according to Scottish Medicines Consortium (SMC) guidance from a National Health Service (NHS) Scotland perspective. Clinical inputs were derived from HCCP trials (e.g., PACE), and health-related quality of life was based on EQ-5D values from HCCP trials. Analyses were conducted for an adult PNP population, and diabetic and non-diabetic etiologies. Costs included drug acquisition, administration, drug and disease monitoring, adverse events, and-in a scenario analysis-societal costs.

Results: For the adult PNP population, HCCP + SoC resulted in an incremental gain of 1.00 quality-adjusted life-years (QALYs) at an additional cost of £13,479, yielding an incremental cost-effectiveness ratio (ICER) of £13,516 per QALY. ICERs for specific etiologies were £11,383 for non-diabetic and £16,442 for diabetic PNP populations. Deterministic and probabilistic sensitivity analyses (PSA) confirmed robustness of the model, with 89% of PSA iterations falling below a £20,000/QALY threshold. Scenario analysis using a societal perspective further improved cost-effectiveness (ICER: £7475).

Conclusions: HCCP is a cost-effective add-on therapy for the treatment of adults with PNP in Scotland, with consistent findings across diabetic and non-diabetic populations. These results support the benefits of integrating HCCP in healthcare systems and clinical practice, both in terms of patient outcomes and economic benefits for the system.

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高浓度（179毫克）辣椒素贴片治疗苏格兰周围神经性疼痛患者的成本效益

简介：周围神经性疼痛（PNP）是一种慢性疾病，口服药物治疗往往不能充分控制。高浓度辣椒素贴剂（HCCP）是一种局部神经溶解治疗PNP的药物。本研究评估了HCCP作为苏格兰PNP患者标准护理（SoC）的附加治疗的成本效益。方法：使用3个月周期和生命周期的马尔可夫模型进行成本-效用分析，以确定在成年PNP患者中，与单独使用SoC相比，HCCP联合SoC的成本-效果。该模型包括五种健康状态（无疼痛、轻度、中度、重度疼痛和死亡），是根据苏格兰医药协会（SMC）从苏格兰国家卫生服务（NHS）的角度制定的。临床输入来自HCCP试验（如PACE），健康相关生活质量基于HCCP试验的EQ-5D值。对成年PNP人群、糖尿病和非糖尿病病因进行了分析。成本包括药物获取、管理、药物和疾病监测、不良事件，以及——在情景分析中——社会成本。结果：对于成年PNP人群，HCCP + SoC导致1.00质量调整生命年（QALYs）的增量收益，额外成本为13,479英镑，每个QALY的增量成本-效果比（ICER）为13,516英镑。非糖尿病人群的ICERs为11,383英镑，糖尿病PNP人群的ICERs为16,442英镑。确定性和概率敏感性分析（PSA）证实了该模型的稳健性，89%的PSA迭代低于£20,000/QALY阈值。使用社会视角的情景分析进一步提高了成本效益（ICER: 7475英镑）。结论：HCCP是苏格兰治疗成人PNP的一种具有成本效益的附加疗法，在糖尿病和非糖尿病人群中都有一致的发现。这些结果支持在医疗保健系统和临床实践中整合HCCP的好处，无论是在患者预后方面还是在系统的经济效益方面。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pain and Therapy CLINICAL NEUROLOGY-

CiteScore

6.60

自引率

5.00%

发文量

110

审稿时长

6 weeks

期刊介绍： Pain and Therapy is an international, open access, peer-reviewed, rapid publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of pain therapies and pain-related devices. Studies relating to diagnosis, pharmacoeconomics, public health, quality of life, and patient care, management, and education are also encouraged. Areas of focus include, but are not limited to, acute pain, cancer pain, chronic pain, headache and migraine, neuropathic pain, opioids, palliative care and pain ethics, peri- and post-operative pain as well as rheumatic pain and fibromyalgia. The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports, trial protocols, short communications such as commentaries and editorials, and letters. The journal is read by a global audience and receives submissions from around the world. Pain and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.