To evaluate the cost-effectiveness of duloxetine 120 mg compared to amitriptyline and other FDA-approved fibromyalgia treatments.
Key Findings:
Duloxetine 120 mg generated more QALYs (10.40) compared to amitriptyline (9.99) at a slightly higher lifetime cost ($115,770 vs $115,145).
The incremental cost-effectiveness ratio for duloxetine 120 mg was $1,536 per QALY.
Duloxetine 120 mg produced an incremental net monetary benefit of $40,075 at a willingness-to-pay threshold of $100,000 per QALY.
Pregabalin and milnacipran regimens were economically dominated by duloxetine 120 mg.
Including indirect costs, duloxetine 120 mg was cost-saving relative to amitriptyline.
Interpretation:
Duloxetine 120 mg offers the greatest economic value for patients with fibromyalgia, emphasizing the need to consider societal costs in treatment decisions.
Limitations:
The model did not fully capture real-world treatment patterns such as dose adjustments or combination therapy.
Cost estimates relied on published data that may vary across different practice settings.
Conclusion:
Duloxetine 120 mg is the most cost-effective treatment option for moderate to severe fibromyalgia among the evaluated drugs.
