NDLI: Budget impact analysis of tapentadol extended release for the treatment of moderate to severe chronic noncancer pain.

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Budget impact analysis of tapentadol extended release for the treatment of moderate to severe chronic noncancer pain.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Merchant, Sanjay Noe, Les L. Howe, Andrew Duff, Steve Gricar, Joe Ogden, Kristine Mody, Samir H.
Spatial Coverage	United States
Description	Country affiliation: United States Author Affiliation: Merchant S ( Janssen Global Services, LLC, Raritan, NJ, USA.)
Abstract	BACKGROUND: Opioids are commonly used to manage chronic pain. Although traditional µ-opioids are effective in reducing pain, they are often associated with opioid-induced side effects (OISEs) that can limit treatment effectiveness. Studies have shown that tapentadol extended release (ER) has a lower incidence of gastrointestinal adverse events than oxycodone controlled release (CR) at equianalgesic doses. OBJECTIVE: A model was developed to estimate the budget impact of placing tapentadol ER on a hypothetical US health plan formulary of Schedule II long-acting opioids. METHODS: We estimated annual direct health care costs for patients who received 6-month therapy with long-acting formulations of tapentadol, oxycodone, morphine, hydromorphone, oxymorphone, or fentanyl. Costs included medications, copayments, OISE management, and switching/discontinuation. Published estimates of incidence/prevalence, OISEs, and pain management resources and costs were used. The base case analysis assumed a 10% formulary share of tapentadol ER with a 10% decrease of oxycodone CR. The resulting per-member per-month (PMPM) formulary cost differences and results of a 1-way sensitivity analysis are reported. RESULTS: In a health plan of 500,000 members, 2600 (0.52%) are estimated to experience chronic pain annually. Adding tapentadol ER to the formulary was associated with an annual budget savings of \$148,945 (\$0.0248 PMPM). This savings was achieved through a decrease in both pharmacy costs (\$144,062; \$0.0240 PMPM) and medical costs (\$4883; \$0.0008 PMPM). Cost decreases were driven by lower daily average consumption and fewer OISEs with tapentadol ER versus oxycodone CR, leading to reduced resource utilization over 6 months of treatment. Sensitivity analyses showed results were most sensitive to drug acquisition costs. CONCLUSIONS: Our results suggest that replacing 10% of oxycodone CR's formulary share with tapentadol ER would decrease the overall budget of a health plan with 500,000 members. Placing tapentadol ER on a health plan formulary may result in a reduction in both pharmacy and medical costs.
File Format	HTM / HTML
ISSN	01492918
Issue Number	5
Volume Number	35
e-ISSN	1879114X
Journal	Clinical Therapeutics
Language	English
Publisher	Elsevier
Publisher Date	2013-05-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Pharmacology Analgesics, Opioid Economics Chronic Pain Drug Therapy Models, Economic Phenols Administration & Dosage Therapeutic Use Budgets Cost Savings Costs And Cost Analysis Delayed-action Preparations Formularies As Topic Health Care Costs Humans Oxycodone Severity Of Illness Index United States Journal Article Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Pharmacology Pharmacology (medical)

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