OBJECTIVES: To evaluate the cost-effectiveness of lidocaine patches for the treatment of localized neuropathic pain through a complete economic evaluation.

METHODS: A systematic review and network meta-analysis (NMA) on the treatment of localized neuropathic pain and a complete cost-effectiveness economic evaluation of lidocaine patches versus pregabalin and gabapentin were performed. Effectiveness was evaluated as the proportion of patients who relieve pain in 30% and 50% in the Numeric Rating Scale (NRS); safety was evaluated as the proportion of patients who did not abandon treatment due to adverse effects and the incidence of dizziness. The cost-effectiveness analysis included a decision tree model with a time horizon of 2 months. A budget impact analysis was performed to estimate the financial impact of including lidocaine patches as a treatment option.

RESULTS: The systematic review and NMA reported no significant difference in pain improvement amongst treatments, however lidocaine patches reported a significantly lower number of patients discontinuing treatment due to adverse events. An incremental effectiveness of lidocaine patches with 94% of patients not abandoning treatment versus 82% and 75% with gabapentin and pregabalin, respectively was estimated. The average cost per patient with lidocaine patches was $173.98 USD, versus $49.57 and $100.32 for gabapentin and pregabalin. The Incremental Cost-Effectiveness Ratio (ICER) was estimated at $1,055.52 and $374.20 versus gabapentin and pregabalin respectively. The impact on the National Health System’s budget of introducing lidocaine patches over a 5-year time horizon averages $4,496,215.43, which represents 0.059% of the system´s drug budget.

CONCLUSIONS: Lidocaine patches are a cost-effective option within Mexico’s Public Health Care system for the treatment of localized neuropathic pain when considering the proportion of patients who do not abandon their treatment due to adverse events.