Fibromyalgia & musculoskeletal pain
Cost-Effectiveness of Pregabalin, Duloxetine, and Milnacipran vs Amitriptyline for Moderate to Severe Fibromyalgia
Main finding · Cost-effectiveness vs amitriptylineResult — go to the resultICER $1536 per QALYAuthors' conclusion
In this decision analytical model, duloxetine 120 mg was the preferred strategy across perspectives; pregabalin 450 mg was economically favorable relative to amitriptyline only when societal costs were included. Amitriptyline provided greater net benefit than milnacipran and the lower doses of pregabalin and duloxetine.
Study context
- Population
- Simulated cohort of adults (aged ≥18 years) with moderate to severe fibromyalgia (FM); 94.4% women, mean (SD) age 48.4 (10.4) yearssimulated cohort
- Exposure
- Pregabalin, duloxetine and milnacipran vs amitriptyline
- Outcome
- Expected lifetime cost, QALYs, incremental cost-effectiveness ratios (ICERs) and iNMB at WTP thresholds of $50 000, $100 000 and $150 000 per QALY
- Follow-up
- Lifetime
Methodological detailscost-effectiveness analysis, Markov cohort state transition model, lifetime horizon, US health care payer and societal perspectives, Data analyzed between September 2024 and February 2025; model inputs derived from published sources
- Cost-effectiveness analysis
- Markov cohort state transition model
- Lifetime horizon
- US health care payer and societal perspectives
- Data analyzed between September 2024 and February 2025; model inputs derived from published sources
Main finding
Cost-effectiveness vs amitriptyline
ICER
$1536 per QALY
As reported in the abstract
Observational data: associations, not effects.
Further findings
Incremental net monetary benefit (iNMB) at $100 000 willingness-to-pay (WTP) threshold · lifetime
- Duloxetine 120 mg, health care payer perspective
- $40 375
- Duloxetine 120 mg, societal perspective
- $70 063
- Pregabalin 450 mg, health care payer perspective
- $21 211
- Pregabalin 450 mg, societal perspective
- $40 190
Original publication
Cost-Effectiveness of Pregabalin, Duloxetine, and Milnacipran vs Amitriptyline for Moderate to Severe Fibromyalgia. JAMA Netw Open. Published 2 February 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →