Cost-Effectiveness Analysis of Tapentadol versus Oxycodone / Naloxone in Branded and Generic Formulations - on Patients with Musculoskeletal Pain
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Abstract
The most common symptom of most musculoskeletal pathologies (MSCs) is pain and the most common is lumbar, occupying the ninth place among the causes of disability.
MSCs are the leading cause of job loss in Europe.
Tapentadol is the first opioid with a dual mechanism of action used in the treatment of severe chronic pain.
Its effectiveness is confirmed both on the nociceptive and neuropathic component of chronic maladaptive pain.
Aims
Analyze the cost-effectiveness of tapentadol in branded formulation in comparison with oxycodone-naloxone.
Methods
The cost-effectiveness analysis was conducted using the third-party perspective. The transition from one state to another was simulated using the Markov model by comparing two arms made up of a hypothetical court of 1,000 individuals.
The efficacy and safety data were extrapolated from the relevant clinical studies.
The time frame is 1 year.
For a correct interpretation of the results, the results of the model were expressed as Net Monetary Benefit (BNM).
A probabilistic sensitivity analysis was performed.
Finally, the scenarios were sorted on a cost-effectiveness acceptability curve. A budget impact analysis was performed.
Results
In all scenarios, tapentadol appears to be dominant.
On average, the comparison leads to a saving of € 254.99 per patient and a BNM of € 1,714.4 per patient. The first year, the introduction of tapentadol produces about € 45 million in savings, 198 in year 2 and 176 in year 3.
Discussion
The results promote the use of tapentadol, confirming the results obtained from previous studies.
The results from the Markov model showed that tapentadol improves patients' quality of life and is less expensive than oxycodone.
Conclusions
Based on the results of the cost effectiveness analysis, tapentadol has a better profile in terms of quality of life at lower costs, being dominant over the therapeutic alternative in both brand and generic formulation, in all scenarios hypothesized in the model.
The budget impact analysis shows that, although tapentadol is more expensive, when the costs of managing adverse events and the costs of stopping treatment are also taken into account, the scenario involving the use of tapentadol turns out to be the most convenient in the perspective of the National Health Service.
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