Tapentadol vs. pregabalina asociada a otros opioides en dolor crónico: análisis de coste-efectividad

摘要

Background: Tapentadol is a new oral analgesic with a dual mode of action as a mu-opioid receptor agonist and as norepinephrine reuptake inhibitor. The cost of treatment can be argued as a problem for prescribing it. Objective: The aim of this study was to compare the cost-effectiveness of tapentadol to that of associations of other opioids with pregabalin. Patients and methods: 21 patients suffering chronic pain under treatment with opioids and pregabalin for more than 3 months and pain poorly controlled (VAS > 4) were proposed to change to tapentadol in a progressive manner: First changing the opioid to tapentadol and then removing pregabalin. Pain (VAS), daily cost of treatments and adverse effects incidence were registered. Results: Four patients returned to prior treatment because of higher incidence of adverse effects. In the group of 17 patients who completed the change of treatment pain improved from 5.7 (VAS) to 3.4 (VAS) (p < 0.001), and the cost of treatment from 4.57 €/day to 3.78 €/day (p < 0.05). Conclusion: Tapentadol treatment may be cost-effective when compared with associations of other opioids and pregabalin in patients suffering moderate to severe chronic pain. More extensive studies must be done in this sense.