OBJECTIVES: Peripheral neuropathic pain (PNP) is caused by lesions or diseases affecting the peripheral somatosensory system. It affects approximately 7-8% of the European population and has a negative impact on the quality of life and work productivity. Treatment of PNP is complex and places a tremendous strain on the healthcare system and the society in general. Besides oral therapies, one option for topical treatment in PNP is high-dose capsaicin 179 mg (or 8%). This study aimed to assess clinical benefits and cost-effectiveness of high-dose capsaicin cutaneous patches for treating PNP of various origins, also in comparison to oral medication.

METHODS: A structured literature search was conducted in PubMed for publications from 2008 onwards. Studies investigating the therapy of PNP with high-dose capsaicin cutaneous patches, regardless of study design, were included. Health economic analyses were identified to evaluate cost effectiveness. Relevant publications were identified through title and abstract screening, and full-text review was performed for complete inclusion. The results of the included publications were qualitatively summarized based on clinical benefits and cost-effectiveness evaluation criteria specific to the German healthcare system.

RESULTS: A total of 33 full-text articles were included in the qualitative assessment. Eight randomized controlled trials demonstrated the efficacy of high-dose capsaicin cutaneous patches in treating PNP of various origins. High-dose capsaicin patches showed comparable reduction of neuropathic pain symptoms with fewer side effects compared to oral therapies. Three publications addressing cost-effectiveness concluded that topical capsaicin therapy is cost effective when compared to oral comparative therapy for PNP.

CONCLUSIONS: The findings from a substantial body of evidence support the effectiveness of high-dose capsaicin cutaneous patches as a topical treatment for PNP. A few publications also suggest the cost-effectiveness of these patches in comparison to oral therapies, although further analyses, particularly within the context of European healthcare systems, are recommended.