OBJECTIVE: To study the cost-effectiveness of four alternative treatments for 
burning mouth syndrome (BMS).
METHODS: A cost-effectiveness analysis was conducted from a healthcare payer 
perspective of four therapy strategies (amisulpride, paroxetine, sertraline and 
topical clonazepam), using a decision-tree model that incorporated direct 
healthcare costs and probabilities associated with the possible events and 
outcomes. Average cost-effectiveness and incremental cost-effectiveness ratios 
were calculated. Sensitivity analyses included the costs of brand name and 
generic drugs in five European countries (France, Italy, the Netherlands, Spain 
and UK), as well as two scenarios with different treatment length.
RESULTS: Of the drugs analysed, topical clonazepam proved to be the most 
cost-effective therapy. Although generic proved more efficient than brand name 
drugs, they displayed no advantage over brand name topical clonazepam. The 
Netherlands was the country with the highest overall drug efficiency. 
Sensitivity analyses highlighted the robustness of the model, because topical 
clonazepam proved to be the most efficient therapy under all the different 
scenarios.
CONCLUSIONS: Topical clonazepam, which previous analyses of clinical evidence 
have shown to be the drug of choice for BMS, also proved to be the most 
cost-effective of the drugs analysed for this condition.