Cost-Effectiveness of Mirogabalin in Treatment of Diabetic Peripheral Neuropathic Pain in Mainland China

OBJECTIVES:

Diabetic peripheral neuropathic pain (DPNP) is a chronic microvascular complication of diabetes mellitus associated with debilitating pain, high morbidity, and poor quality of life. The objective of this study was to compare the cost-effectiveness of mirogabalin, a potent and selective αlpha-2-delta ligand, with pregabalin in patients with DPNP from the healthcare system perspective in mainland China.

METHODS:

A Markov model was implemented, with health states defined as ‘mild’ (average daily pain score (ADPS) < 4), ‘moderate’ (4 ≤ ADPS < 7), and ‘severe’ (7 ≤ ADPS ≤ 10) pain. The time horizon was one year with the model cycle of two weeks. At the end of each cycle, patients remained in the same health state, or transitioned to a different health state according to the change in their ADPSs. Clinical inputs were obtained from a network meta-analysis (NMA) comparing the efficacy and safety between mirogabalin and pregabalin. Healthcare resource utilization and cost inputs were informed by Chinese clinical experts and literature review. Utility inputs for each health state were derived from existing literature. Probabilistic sensitivity analysis was performed.

RESULTS:

Compared with pregabalin 300mg, mirogabalin 30mg was cost-effective with an ICER of CNY 49,057/QALY, which is well below the willingness-to-pay threshold of 1 times GDP per capita in China (CNY 80,976). Sensitivity analysis results demonstrated the robustness of the results, with 82.2% of simulations confirming the cost-effectiveness of mirogabalin.

CONCLUSIONS:

The model results suggested that mirogabalin is a cost-effective treatment option for patients with DPNP in mainland China.