Economic evaluation of Durogesic in moderate to severe, nonmalignant, chronic pain in Germany.
We carried out a cost-effectiveness evaluation of transdermal fentanyl compared to three other widely used opioids: transdermal buprenorphine, sustained-release morphine, and controlled-release oxycodone from a third-party-payers perspective. A decision analytic model with data from a structured database search and from panel data and assumptions was used to derive both cost and utility results. Probabilistic sensitivity analysis was performed to ensure the findings. Transdermal fentanyl patients gain more quality adjusted life-days or quality-adjusted life-years per euro. The incremental cost per quality-adjusted life-year is 1,625.65 euro for transdermal fentanyl compared to sustained-release morphine and 1,003.03 euro compared to CO, and it is cost-saving compared to transdermal buprenorphine (-203.38 euro per patient). Transdermal fentanyl is thus cost-effective compared to both sustained-release morphine and CO and dominant compared to transdermal buprenorphine in the treatment of adults with nonmalignant moderate to severe chronic pain.
Greiner
W
W
Department of Health Economics and Health Management, University of Bielefeld, Germany. wolfgang.greiner@uni-bielefeld.de
Lehmann
K
K
Earnshaw
S
S
Bug
C
C
Sabatowski
R
R
D000279:Administration, Cutaneous; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use*; D002047:Buprenorphine / Q000191:economics / Q000627:therapeutic use; D002908:Chronic Disease; D003362:Cost-Benefit Analysis; D003692:Delayed-Action Preparations; D005283:Fentanyl / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use*; D005858:Germany; D006296:Health Services / Q000706:statistics & numerical data; D006801:Humans; D009020:Morphine / Q000191:economics / Q000627:therapeutic use; D010098:Oxycodone / Q000191:economics / Q000627:therapeutic use; D010146:Pain / Q000188:drug therapy*; D019057:Quality-Adjusted Life Years
D000701:Analgesics, Opioid; D003692:Delayed-Action Preparations; D002047:Buprenorphine; D009020:Morphine; D010098:Oxycodone; D005283:Fentanyl