Cost-Effectiveness of a High-Concentration (179 mg) Capsaicin Patch for the Treatment of Patients with Peripheral Neuropathic Pain in Scotland
Abstract
Peripheral neuropathic pain (PNP) is a chronic condition often inadequately controlled by oral pharmacologic treatments. High-concentration capsaicin patch (HCCP) is a topical neurolytic treatment for PNP. This study assessed the cost-effectiveness of HCCP as an add-on to standard of care (SoC) in patients with PNP in Scotland. A cost-utility analysis was conducted using a Markov model with 3-month cycles and a lifetime horizon to determine the cost-effectiveness of HCCP added-on to SoC compared to SoC alone, in adult patients with PNP. The model included five health states (no pain, mild, moderate, severe pain, and death) and was developed according to Scottish Medicines Consortium (SMC) guidance from a National Health Service (NHS) Scotland perspective. Clinical inputs were derived from HCCP trials (e.g., PACE), and health-related quality of life was based on EQ-5D values from HCCP trials. Analyses were conducted for an adult PNP population, and diabetic and non-diabetic etiologies. Costs included drug acquisition, administration, drug and disease monitoring, adverse events, and—in a scenario analysis—societal costs. For the adult PNP population, HCCP + SoC resulted in an incremental gain of 1.00 quality-adjusted life-years (QALYs) at an additional cost of £13,479, yielding an incremental cost-effectiveness ratio (ICER) of £13,516 per QALY. ICERs for specific etiologies were £11,383 for non-diabetic and £16,442 for diabetic PNP populations. Deterministic and probabilistic…
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