OBJECTIVES: Neuropathic pain is caused by various disorders affecting the central and peripheral nervous system. Its most common causes are secondary to herpes zoster infection and as a complication of diabetes mellitus. The aim of this analysis is to evaluate the cost-effectiveness of pregabalin versus duloxetine to estimate the pain reduction in diabetic neuropathy and postherpetic neuralgia from the social perspective in Colombia. METHODS: A Markov model was developed with 3 health-states: improvement (pain reduction >50% using visual analogue scale [VAS] against baseline), no improvement and treatment discontinuation (due to therapeutic failure). The time horizon is of 5 years (three-month cycles) and discounts annually effectiveness and costs using a 3% rate. Comparators were pregabalin (150-300 mg/day) vs. duloxetine (60 mg/day). Population (>18 years) with neurophatic pain was estimated in 775,152 for Colombia. Effectiveness and utility data were taken from a literature and meta-analysis of controlled clinical trials. Costs were taken from official tariff manuals, pricing laws and from the local health insurance company SURA. Costs are presented in 2012 USD. Effectiveness measure was Quality Adjusted Life Years (QALYs). RESULTS: Over a 5-year period, pregabalin obtained 231,105 QALYs more than duloxetine (1,003,720 and 772,615 QALYs, respectively). Total expected savings with pregabalin was USD439.5M compared to duloxetine (total expected costs: USD664.8M and USD1,104.4M, respectively); costs for medical disabilities (sick leaves) were USD43.8 lower with pregabalin than duloxetine. Probabilistic sensitivity analyses showed the robustness of the model. CONCLUSIONS: Pregabalin is shown to be a cost-saving alternative compared with duloxetine for the treatment of neuropathic pain; pregabalin would have a higher rate of patients with reduction pain (51%) than duloxetine (41%), a larger number of QALYs and would have savings (USD567.1 per patient) due to lower costs of treatment and fewer payments for medical disabilities.