OBJECTIVES

The objective of this study was to assess the cost-effectiveness of mirogabalin versus no treatment or pregabalin in patients with diabetic peripheral neuropathic pain (DPNP) from the third-party perspective in Taiwan.

METHODS

A Markov model, informed by a pragmatic literature review, was developed with cycles of 2 weeks and a time horizon of 1 year. The model consisted of three health states: ‘mild’, ‘moderate’ and ‘severe’ pain. Average daily pain score (ADPS) is assessed at the end of each 2-week cycle. All patients entered the model in the 'moderate' (4 ≤ ADPS <7) or 'severe' (7 ≤ ADPS ≤ 10) pain health states. At the end of each 2-week cycle, patients remained in their assigned health state or transitioned to a different health state according to the change in their pain scores. Efficacy data was informed by the pivotal clinical trial, J303, or by a network meta-analysis (NMA). Utility values for each health state were obtained from published literature. Resource use and cost data were obtained from Taiwanese clinical experts and the Taiwan National Health Insurance Administration. Probabilistic analysis was conducted to test the robustness of results.

RESULTS

Results from the head-to-head analysis show that mirogabalin 30mg is a cost-effective treatment option versus no treatment for DPNP in Taiwan. The deterministic analysis estimated a QALY gain of 0.02 at an incremental cost of NT$9,697 (US$323) versus no treatment with an ICER of NT$489,310 (US$15,860). In the analyses using NMA efficacy data, mirogabalin 30mg was cost-effective when compared to pregabalin 300mg with an ICER of NT$18,476 (US$600). Results from sensitivity and scenario analyses confirmed these results.

CONCLUSIONS

Results from this economic analysis suggest that mirogabalin 30mg, a potent and selective αlpha-2-delta ligand, is a cost-effective treatment option for DPNP in Taiwan with an ICER below the willingness-to-pay threshold.