Scoping Review of Cost-Effectiveness Analysis of Pharmacotherapy for Painful Diabetic Neuropathy

Implications for Studies in Japan

Abstract

Painful diabetic neuropathy (PDN), which occurs in 30% of patients with diabetes, reduces quality-of-life (QOL), but active intervention is accompanied with financial challenges and requires more cost-effective drug selection for intervention. The purpose of this scoping review is to examine the results and issues on the cost-effectiveness analysis (CEA) of PDN treatment in other countries and to discuss ways to proceed with CEA in Japan. MEDLINE and Embase were used for the search, and 10 studies were selected from 829 studies from 2005 to 2020 for examination. The examination clarified that the model structure and the setting of utility values differed depending on the characteristics of drugs focused on in the CEA of PDN treatment (e.g., definition of pain relief, adverse events, etc.), and the results differ as well. CEA based on pain intensity showed the superiority of pregabalin, but did not reflect the impact of factors other than pain on QOL or the diversity of PDN treatment over the long term. For future CEAs, it is desirable to ascertain the utility values and QOL associated with intervention effects and adverse events by conducting clinical trials for the analysis, and to expand the grasp of actual conditions in daily practice and ensure transparency in this process.