Neuropathic pain (NeP) is a pain caused by a lesion or disease of the somatosensory nervous system (International Association for the Study of Pain – IASP 2011). In many cases NeP is secondary to herpes zoster infection and as a complication of diabetes mellitus. This study aimed to assess the budget impact of pregabalin in NeP in adult Colombian population. A budget impact model was developed with a time horizon of 1 year from the social perspective (direct and indirect costs included). Cohort contains 155,030 patients over 18 years with NeP, according to Colombian prevalence and considers 20% of patients have access to medical treatment. Direct costs (drug acquisition, medical visits with general practitioners, specialists and emergency visits) and indirect costs (disability payments) of managing patients with neuropathic pain were estimated from Colombian sources (tariff manuals and pricing rulings). Comparators included those locally approved for NeP: pregabalin (150-300 mg/day) versus duloxetine (60 mg/day). Univariate deterministic and probabilistic sensitivity analyses were done. Costs are in 2012 US$. Assuming that each comparator had a 100% market share, the average total costs of treating NeP patients for 1 year, with the comparators were: pregabalin US $132,965,443 (51.7% drug acquisition, 26.4% medical visits and 21.9% indirect costs) and duloxetine US $220,883,844 (68.6% drug acquisition, 14.2% medical visits and 17.2% indirect costs). Patients taking pregabalin have a lower acquisition cost of drugs. Pregabalin is a favorable alternative for the treatment of NeP compared to duloxetine by saving US $567.1 per patient/year compared to duloxetine. Colombian stakeholders should consider these findings for future decision-making processes.