title: [Economic evaluation of tramadol/paracetamol in the management of pain in patients with osteoarthritis in Spain].
abstract: OBJECTIVE
  To compare the costs of treating osteoarthritis (OA) pain using combination tramadol/paracetamol tablets, Non-Steroidal Anti-Inflammatory Agents (NSAID) alone or NSAID plus proton pump inhibitors (PPI) from the perspective of the Spanish National Health System.
  
  
  METHODS
  A decision-analytical model was constructed to analyze the cost associated with three treatment strategies over 6 months. A cost-minimization approach was used, which considered data related to resource use, medication costs and costs for the treatment of adverse events.
  
  
  RESULTS
  In the base-case analysis, costs for 6 months of treatment of OA pain using tramadol/paracetamol were €232.86, compared with €274.60 for NSAID + PPI and €133.75 for NSAID alone. This provided a savings of €41.74 per patient over 6 months for tramadol/paracetamol compared with NSAID + PPI and a cost increase of €99.11 compared with NSAID alone. When renal adverse events associated with NSAID were considered, tramadol/paracetamol was cost saving compared with all NSAID-based regimens (saving €140.02 vs NSAID alone, €280.86 vs NSAID + PPI).
  
  
  CONCLUSIONS
  Based on the results of a theoretical decision-analytic model, the data obtained may suggest that tramadol/paracetamol is cost saving compared with NSAID + PPI for the treatment of OA pain over a period of 6 months. Tramadol/paracetamol is also cost saving compared with treatment with NSAID alone if considering renal adverse events.
authors.affiliation: Servicio de Reumatología, Hospital General Universitario de Guadalajara. Guadalajara. España.
authors.forename: Javier
authors.initials: J
authors.lastname: Vidal
authors.forename: Pere
authors.initials: P
authors.lastname: Benito
authors.forename: Anna
authors.initials: A
authors.lastname: Manresa
authors.forename: Domingo
authors.initials: D
authors.lastname: Ly-Pen
authors.forename: Enrique
authors.initials: E
authors.lastname: Batlle
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Blanco
authors.forename: Max
authors.initials: M
authors.lastname: Brosa
authors.forename: Diana
authors.initials: D
authors.lastname: Nieves
mesh_terms: D000082:Acetaminophen / Q000191:economics* / Q000627:therapeutic use*; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use*; D000701:Analgesics, Opioid / Q000191:economics* / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D006801:Humans; D010003:Osteoarthritis / Q000150:complications*; D010146:Pain / Q000188:drug therapy* / Q000191:economics* / Q000209:etiology; D013030:Spain; D014147:Tramadol / Q000191:economics* / Q000627:therapeutic use*
chemical_list: D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D000082:Acetaminophen; D014147:Tramadol