西班牙肌肉骨骼疼痛患者服用他喷他多 PR 与羟考酮/纳洛酮 PR 的成本效益分析

Yoana Ivanova-Markova, Almudena González-Domínguez, Mathilde Daheron, Ana Durán, Santiago Almazán Carneros, Sara Rubio Broniowski
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摘要

研究目的慢性肌肉骨骼疼痛在全球范围内非常普遍,造成了巨大的社会和经济负担。根据欧洲疼痛联合会的建议,阿片类药物是治疗慢性疼痛的常用处方药。他喷他多缓释剂(PR)是一种强效阿片类药物,已被证明能有效治疗慢性肌肉骨骼疼痛,且不良反应少于羟考酮/纳洛酮缓释剂。本研究的目的是从西班牙国家医疗保健系统(SNHS)的角度来估算与羟考酮/纳洛酮缓释剂相比,他喷他多缓释剂的成本效益。 方法:采用马尔可夫模型对两组患者进行分析:接受他喷他多 PR 治疗的患者和接受羟考酮/纳洛酮 PR 治疗的患者。该模型对为期一年的 1000 名患者进行了评估。结果总体而言,使用他喷他多 PR 治疗患者的成本低于使用羟考酮/纳洛酮 PR 治疗患者的成本(388,631.70 欧元 vs 568,168.85 欧元)。就成本效益而言,与羟考酮/纳洛酮 PR 相比,他喷他多 PR 的增量成本为-179,537.15 欧元,质量调整生命年增量值为 40.05。每质量调整生命年的增量成本效益比估计为-4,027.16 欧元,这表明与羟考酮/纳洛酮 PR 相比,他喷他多 PR 是一种经济上占优势的替代方案。 结论在西班牙,他喷他多 PR 是治疗肌肉骨骼慢性疼痛患者的一种经济有效的选择。关键词:肌肉骨骼疼痛肌肉骨骼疼痛 阿片类药物 塔喷他多 PR 成本效益 西班牙
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Cost‑Effectiveness Analysis of Tapentadol PR Versus Oxycodone/Naloxone PR in Patients with Musculoskeletal Pain in Spain
Objetive: Chronic musculoskeletal pain is highly prevalent worldwide and is associated with a huge social and economic burden. Opioids are commonly prescribed to treat chronic pain as recommended by the European Pain Federation. Tapentadol prolonged release (PR), is a strong opioid that has proven being effective in treating chronic musculoskeletal pain with less adverse events than oxycodone/naloxone PR. The aim of this study was to estimate the cost-effectiveness of tapentadol PR compared to oxycodone/naloxone PR from the Spanish National Healthcare System perspective (SNHS). Methods: A Markov model was adapted analysing two arms: patients treated with tapentadol PR and patients treated with oxycodone/naloxone PR. The model assesses a cohort of 1,000 patients over a one-year period. Results: Overall, treating patients with tapentadol PR was less costly than treating patients with oxycodone/naloxone PR (€388,631.70 vs €568,168.85). In terms of cost effectiveness, the incremental cost of tapentadol PR over oxycodone/naloxone PR was -€179,537.15 and the incremental quality-adjusted life year value was 40.05. The incremental cost-effectiveness ratio was estimated at -€4,027.16 per quality-adjusted life year suggesting that tapentadol PR is an economically dominant alternative over oxycodone/naloxone PR. Conclusion: Tapentadol PR represents a cost-effective option to treat musculoskeletal chronic pain patients in Spain. Keywords: Musculoskeletal pain, Opioids, Tapentadol PR, Cost effectiveness, Spain.
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