Cost-Effectiveness of Pregabalin, Duloxetine, and Milnacipran vs Amitriptyline for Moderate to Severe Fibromyalgia

Among adults with moderate to severe fibromyalgia, how do pregabalin, duloxetine, and milnacipran compare with amitriptyline in terms of cost-effectiveness?In this decision analytical model, duloxetine 120 mg and pregabalin 450 mg were more effective and less costly than amitriptyline from the societal perspective. Other evaluated strategies, including lower doses of duloxetine and pregabalin and milnacipran regimes, were dominated by amitriptyline.These findings suggest that whereas most other options provided inferior value, duloxetine 120 mg and pregabalin 450 mg offered greater health benefits at lower costs than amitriptyline in moderate to severe fibromyalgia when societal costs were considered.

Corresponding Author: Tewodros Eguale, MD, PhD, Department of Pharmaceutical Economics and Policy, Massachusetts College of Pharmacy and Health Sciences, 179 Longwood Ave, Boston, MA 02115 (tewodros.eguale@mcphs.edu); Ismaeel Yunusa, PharmD, PhD, MPH, Department of Clinical Pharmacy and Outcomes Sciences, College of Pharmacy University of South Carolina, 715 Sumter St, Columbia, SC 29229 (iyunusa@mailbox.sc.edu).

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