PSY32 Cost- Effectiveness Analysis of Parecoxib in the Management of Postsurgical Pain in Mexico

Abstract

OBJECTIVES: Hemophilia B is a rare and expensive to treat disease. The aim of this study was to develop an economic evaluation of prophylactic vs on-demand supply of recombinant factor IX (rFIX) in the treatment of patients with severe hemophilia B, from the Social Security Mexican Institute (IMSS) perspective. METHODS: A three-state Markov model (two-week cycles) following male patients from birth up to 75 years was developed to estimate the cost and outcomes of prophylactic (30 IU/kg body weight/week) and on-demand (40 IU/kg body weight/joint bleed) approaches to manage haemophilia B. On-demand was considered the usual practice. Effectiveness measure was the QALY. A literature review was performed to extract Mexican demographic and general epidemiologic data needed to populate the model. Treatment cost data (inpatient, outpatient, emergency services, medicines, laboratory and image studies) were extracted from Mexican published databases (the acquisition cost of rFIX was provided by the manufacturer). Health and economic consequences were assessed in different age groups. Both costs and outcomes were discounted at 5% annual rate Probabilistic sensitivity analyses and acceptability curves were constructed. RESULTS: Cost of rFIX in prophylaxis represented 60.3% and 90.4% of the total annual cost in the Յ4 years and Ͼ19 years groups, respectively. In on-demand approach, the cost of the therapy represented 45.3% and 83.9% in the Յ4 years and Ͼ19 years group, respectively. The incremental effectiveness for rFIX is close to one QALY in all age groups. ,291/QALY gained, respectively. Acceptability curves showed an inverse relationship between age and cost-effective proportion. CONCLUSIONS: At IMSS setting, the prophylaxis with rFIX for the management of patients suffering severe hemophilia B appears to be a highly costeffective and a cost-effective intervention in children and teenagers, respectively.

The Economic Impact of Opioid Use in the Management of Chronic Nonmalignant Pain

“…68,69 In addition, use of opioids and NSAIDs concurrently is mutually dose sparing, thus reducing the potential for AEs and associated costs with both drug classes. [70][71][72][73][74] This dose-sparing effect allows patients who require opioid therapy to use lower doses of NSAIDs and opioids, providing good pain relief and lowering the risk of complications associated with either drug.…”