Quality of life benefits and cost impact of prolonged release oxycodone/naloxone versus prolonged release oxycodone in patients with moderate-to-severe non-malignant pain and opioid-induced constipation: a UK cost-utility analysis

Abstract

In the base case, direct treatment costs were slightly higher for patients treated with OXN than for those treated with OXY. However, patients treated with OXN experienced a quality of life gain, and had an ICER considerably below thresholds commonly applied in the UK. The model was most sensitive to the estimated cost of constipation with a number of realistic scenarios in the sensitivity analysis demonstrating a cost saving with OXN (OXN dominant). OXN is therefore estimated to be a cost-effective option for treating patients with severe non-malignant pain and OIC.

Combined oral prolonged-release oxycodone and naloxone in chronic pain management

“…SF-36 scores were converted into EQ-5D utility values to calculate the quality-adjusted life year. Direct treatment costs were slightly higher for patients treated with PR OXN than for those treated with PR OX, but patients treated with PR OXN experienced a quality of life gain, and had an incremental cost-effectiveness ratio considerably below thresholds commonly applied in the United Kingdom [25].…”

Effectiveness and tolerability of low-dose oral oxycodone/naloxone added to anticonvulsant therapy for noncancer neuropathic pain: an observational analysis

“…Although direct evidence of the additional benefit of the PR OXN combination compared with a strong opioid on its own or with a laxative is still lacking, the cost effectiveness of the PR OXN combination has been recently documented in patients with non-cancer pain by comparing the cost of analgesic agents, laxatives and other resources, and benefits obtained with different treatments 38 : patients treated with PR OXN experienced a quality of life gain, with an incremental cost-effectiveness ratio well below the commonly applied thresholds. In fact, in our observation, PR OXN was associated with a marked reduction in the number of patients taking laxatives, as well as a reduction in their weekly dose (from T0 to T3: À37% and À55%, respectively).…”

“…There is robust evidence that PR OXN is effective in reducing OIBD, while maintaining analgesia in patients with chronic pain of noncancer and cancer aetiology -RCTs and post-marketing observations have documented the efficacy and safety of PR OXN combination, with an improvement in bowel function and a substantial reduction in the use of laxatives [16][17][18][19] . Improved QoL and reduced GI events with PR OXN combination may lead to better cost effectiveness compared with oxycodone monotherapy 38 . In the present study, all patients complained of constipation (spontaneous or drug-induced) at baseline.…”

Are we able to Manage Effectively Opioid-Induced Bowel Dysfunction?

“…Such an approach allows avoiding rectal measures that may affect patients' quality of life [17]. However, long-term safety of opioid receptor antagonists are not well established [18,19] and high costs of such therapies may be an important issue, although recent pharmacoeconomic analyses of oxycodone/naloxone provided encouraging results [20].…”