RESUMO
Objetivo. Comparar el coste del tratamiento del dolor en la osteoartrosis (OA) con tramadol/paracetamol frente a los antiinflamatorios no esteroideos (AINE) solos o en combinación con un inhibidor de la bomba de protones (IBP) desde el punto de vista del Sistema Nacional de Salud de España. Métodos. Se realizó un modelo analítico de decisiones que evaluó los costes derivados de las tres estrategias de tratamiento durante 6 meses. Se utilizó un análisis de minimización de costes considerando datos referentes al uso de recursos, costes farmacológicos y costes derivados del tratamiento de los acontecimientos adversos (AA) de la medicación. Resultados. En el análisis del caso base, el coste del tratamiento del dolor de la OA durante 6 meses con tramadol/paracetamol fue de 232,86 , comparado con 274,60 con los AINE + IBP y 133,75 con los AINE solos. Por tanto, el tratamiento con tramadol/paracetamol produce un ahorro de 41,74 por paciente durante 6 meses respecto a AINE + IBP y un coste adicional de 99,11 respecto a los AINE solos. Al considerar los AA renales, tramadol/paracetamol produce un ahorro comparado con los tratamientos que contienen AINE (140,02 respecto de los AINE solos y 280,86 respecto de los AINE + IBP). Conclusiones. Basándose en los resultados de un modelo teórico analítico de decisiones, los datos sugieren que tramadol/paracetamol produce ahorros comparado con los AINE + IBP en el tratamiento del dolor de la OA durante 6 meses. Tramadol/paracetamol también produce ahorros comparado con los AINE solos si se consideran los AA renales (AU)
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). Conclusion. 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 (AU)
Assuntos
Humanos , Masculino , Feminino , Tramadol/economia , Tramadol/uso terapêutico , Acetaminofen/uso terapêutico , Dor/tratamento farmacológico , Dor/economia , Osteoartrite/economia , Osteoartrite/epidemiologia , Anti-Inflamatórios não Esteroides/economia , Custos e Análise de Custo/economia , Custos e Análise de Custo/métodos , Dor/epidemiologia , Espanha/epidemiologia , Anti-Inflamatórios não Esteroides/uso terapêutico , Tramadol/efeitos adversos , Acetaminofen/efeitos adversosRESUMO
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). CONCLUSION: 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.
