PMID- 21194601
OWN - NLM
STAT- MEDLINE
DCOM- 20110425
LR  - 20181201
IS  - 1879-114X (Electronic)
IS  - 0149-2918 (Linking)
VI  - 32
IP  - 10
DP  - 2010 Sep
TI  - Cost-effectiveness analysis of tapentadol immediate release for the treatment of 
      acute pain.
PG  - 1768-81
LID - 10.1016/j.clinthera.2010.09.011 [doi]
AB  - BACKGROUND: Tapentadol immediate-release (IR) tablets are indicated for the 
      treatment of moderate to severe acute pain. In clinical trials, tapentadol IR 
      effectively reduced moderate to severe pain with improved tolerability compared 
      with oxycodone IR at doses providing comparable analgesia. OBJECTIVE: This 
      analysis compared the cost-effectiveness of tapentadol IR with doses of oxycodone 
      IR providing comparable analgesia in the outpatient treatment of acute 
      postsurgical and nonsurgical pain. The perspective was that of a US managed care 
      health plan as third-party payer. METHODS: A Markov model was developed to 
      simulate clinical-economic outcomes for tapentadol IR 100 mg compared with 
      oxycodone IR 15 mg in the treatment of acute postsurgical pain (3 days) and for 
      tapentadol IR 50 mg compared with oxycodone IR 10 mg in the treatment of acute 
      nonsurgical pain (10 days). The model simulated changes in pain relief; 
      occurrence of opioid-related adverse events (AEs); opioid switching, 
      discontinuation, and dose change; and number of quality-adjusted life-days 
      (QALDs). Data inputs for the model were obtained from clinical trials, claims 
      databases, surveys, Medicare fee schedules, and other published sources. Only 
      direct costs were included. Drug costs were based on the wholesale acquisition 
      cost. Prescription copayments were set at $5 for oxycodone IR and $25 for 
      tapentadol IR. All costs were in 2008 US dollars. Sensitivity analyses were 
      conducted on key model parameters. RESULTS: The cost of pain medication per 
      patient was higher for tapentadol IR than for oxycodone IR in both the surgical 
      pain setting ($15.23 vs $9.57, respectively) and the nonsurgical pain setting 
      ($57.17 vs $21.31). However, this cost difference was offset by reductions in 
      pharmacy and medical costs associated with the treatment of AEs and opioid 
      switching/discontinuation, resulting in a lower mean treatment cost per patient 
      for tapentadol IR 100 mg compared with oxycodone IR 15 mg in the treatment of 
      acute surgical pain ($52.90 vs $55.99) and for tapentadol IR 50 mg compared with 
      oxycodone IR 10 mg in the treatment of acute nonsurgical pain ($139.48 vs 
      $144.79). Tapentadol IR also was associated with a greater mean number of 
      treatment days with >/=30% improvement in pain intensity without opioid-related AEs 
      compared with oxycodone IR and a greater mean number of QALDs (surgical pain: 
      1.73 vs 1.68; nonsurgical pain: 6.03 vs 4.92). Because both doses of tapentadol 
      IR were dominant (ie, lower treatment costs and greater effectiveness) relative 
      to the corresponding doses of oxycodone IR providing com- parable analgesia, 
      incremental cost-effectiveness ratios were not calculated. CONCLUSION: The 
      results of this model suggest that at doses providing comparable analgesia, 
      tapentadol IR is a cost-effective alternative to oxycodone IR for the treatment 
      of acute surgical and nonsurgical pain.
CI  - Copyright A(c) 2010 Excerpta Medica Inc. All rights reserved.
FAU - Kwong, W Jacqueline
AU  - Kwong WJ
AD  - Johnson & Johnson Pharmaceutical Services, L.L.C., Raritan, New Jersey, USA.
FAU - Ozer-Stillman, Ipek
AU  - Ozer-Stillman I
FAU - Miller, Jeffrey D
AU  - Miller JD
FAU - Haber, Noah A
AU  - Haber NA
FAU - Russell, Mason W
AU  - Russell MW
FAU - Kavanagh, Shane
AU  - Kavanagh S
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Clin Ther
JT  - Clinical therapeutics
JID - 7706726
RN  - 0 (Analgesics, Opioid)
RN  - 0 (Phenols)
RN  - 0 (Tablets)
RN  - CD35PMG570 (Oxycodone)
RN  - H8A007M585 (Tapentadol)
SB  - IM
MH  - Acute Disease
MH  - Analgesics, Opioid/administration & dosage/adverse effects/*economics/therapeutic 
      use
MH  - Computer Simulation
MH  - Cost-Benefit Analysis
MH  - Dose-Response Relationship, Drug
MH  - Humans
MH  - Markov Chains
MH  - Models, Econometric
MH  - Oxycodone/administration & dosage/adverse effects/*economics/therapeutic use
MH  - Pain/*drug therapy/economics
MH  - Pain Measurement
MH  - Pain, Postoperative/drug therapy/economics
MH  - Phenols/administration & dosage/adverse effects/*economics/therapeutic use
MH  - Quality-Adjusted Life Years
MH  - Solubility
MH  - Tablets
MH  - Tapentadol
EDAT- 2011/01/05 06:00
MHDA- 2011/04/26 06:00
CRDT- 2011/01/04 06:00
PHST- 2010/08/05 00:00 [accepted]
PHST- 2011/01/04 06:00 [entrez]
PHST- 2011/01/05 06:00 [pubmed]
PHST- 2011/04/26 06:00 [medline]
AID - S0149-2918(10)00320-6 [pii]
AID - 10.1016/j.clinthera.2010.09.011 [doi]
PST - ppublish
SO  - Clin Ther. 2010 Sep;32(10):1768-81. doi: 10.1016/j.clinthera.2010.09.011.