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2018 ; 10
(4
): 2321-2330
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Pregabalin as an analgesic option for patients undergoing thoracotomy: cost
analysis of pregabalin versus epidural analgesia for post-thoracotomy pain
relief
#MMPMID29850137
Matsutani N
; Yamane H
; Suzuki T
; Murakami A
; Haga Y
; Kawamura M
J Thorac Dis
2018[Apr]; 10
(4
): 2321-2330
PMID29850137
show ga
BACKGROUND: Our previous randomized controlled trial (RCT) to evaluate the
effects of pregabalin on acute post-thoracotomy pain compared with epidural
analgesia showed that pregabalin is a safe and effective treatment and that it
may be an alternative to epidural analgesia for acute post-thoracotomy pain. In
this analysis, to additionally analyze the economic aspects of pregabalin in
patients undergoing thoracotomy, we compared the medical costs between pregabalin
and epidural analgesia as an analgesic technique for post-thoracotomy pain.
METHODS: Costs for patients undergoing thoracotomy and receiving either
pregabalin or epidural analgesia for post-thoracotomy pain relief in the previous
RCT were retrospectively collected from health insurance claims data. The
following five cost categories were compared between the groups: (I) surgery
costs; (II) costs for surgical materials and medications; (III) costs for
anesthetic management; (IV) total hospitalization costs; and (V) costs for
outpatient pain-relief medications (from hospital discharge to 6 months after
thoracotomy). RESULTS: We analyzed data from 90 patients (45 patients for each
group). Median costs for surgical materials and medications and those for
anesthetic management were significantly lower in the pregabalin group than in
the epidural analgesia group [(Japanese yen) ¥69,720 vs. ¥77,180, P=0.017;
¥161,000 vs. ¥195,500, P<0.001, respectively]. However, total hospitalization
costs and costs for outpatient pain-relief medications were similar between the
groups. Pregabalin was prescribed to more patients in the pregabalin group than
those in the epidural analgesia group as outpatient treatment (75.0% vs. 37.5%),
but median prescribed doses were much smaller in the pregabalin group.
CONCLUSIONS: Although the use of pregabalin did not result in lower total
hospitalization costs, it may reduce fee-for-service surgery- and
anesthesia-related costs. The economic benefits of pregabalin may reinforce its
usefulness as an alternative to epidural analgesia, especially for patients who
are unsuitable for epidural analgesia.