In this decision-analytic model of adults with moderate to severe fibromyalgia, duloxetine 120 mg provided the greatest value, yielding higher quality-adjusted life-years than amitriptyline at a marginally higher cost from the payer perspective and becoming cost-saving when societal costs were included, while pregabalin 450 mg was cost-effective only from the societal perspective. Lower doses of duloxetine and pregabalin and both milnacipran regimens were economically dominated, offering fewer quality-adjusted life-years at higher costs, highlighting the importance of dose optimization and inclusion of indirect costs in value-based treatment selection.

Source: JAMA Network Open