Open Access Open Access  Restricted Access Subscription or Fee Access

Economic evaluation of OROS® hydromorphone for chronic pain: A Pan-European perspective

A. Brett Hauber, PhD, Jochen Fleischmann, PhD, Mickael Lothgren, PhD, Michele Wilson, MSPH, Annette Lam, MHEcon, Dominique Dubois, MD, Rainer Sabatowski, MD

Abstract


Objectives: OROS® hydromorphone (osmotic extended-release oral delivery system [OROS] hydromorphone) is a long-acting opioid analgesic, which is approved in Europe for the management of severe pain. The authors aimed to estimate the economic value of this product relative to other widely used oral opioids, including sustained-release morphine, extended-release (ER) oxycodone, and twice-daily (bid) hydromorphone.
Design: An adaptable, decision-analytic cost-utility model was developed. Separate versions of the model were developed for five European countries: Germany, Denmark, Slovakia, Portugal, and Italy.
Results: OROS hydromorphone represents a cost-effective alternative to other strong oral opioids in the treatment of both nonmalignant and malignant pain in all five countries. In the treatment of chronic severe nonmalignant pain, OROS hydromorphone was dominant (ie, lower cost and incremental quality-adjusted life years gains) when compared with ER oxycodone in Denmark and bid hydromorphone in Germany. Likewise, OROS hydromorphone was dominant in the treatment of chronic severe malignant pain when compared with ER oxycodone in both Germany and Denmark and when compared with bid hydromorphone in all markets where hydromorphone was marketed.
Conclusions: This model demonstrates the cost effectiveness of OROS hydromorphone relative to other strong oral opioids in the treatment of chronic severe malignant and nonmalignant pain.


Keywords


OROS hydromorphone, chronic pain, economics

Full Text:

PDF

References


Harstall C: How prevalent is chronic pain? Pain Clin Updates. 2003; 11(2): 1-4.

Breivik H, Collett B, Ventrafridda V, et al.: Survey of chronic pain in Europe: Prevalence, impact on daily life, and treatment. Eur J Pain. 2006; 10: 287-333.

Gupta SK, Sathyan G: Advances in the long-term management of chronic pain: Recent evidence with OROS® hydromorphone, a novel, once-daily, long-acting opioid analgesic: Providing constant analgesia with OROS® hydromorphone. J Pain Symptom Manage. 2007; 33: S19-S24.

Palangio M, Northfelt DW, Portenoy RK, et al.: Dose conversion and titration with a novel, once-daily, OROS® osmotic technology, extended-release hydromorphone formulation in the treatment of chronic malignant and nonmaligant pain J Pain Symptom Manage. 2002; 23: 355-368.

Wallace M, Rauck RL, Moulin D, et al.: Once-daily OROS hydromorphone for the management of chronic nonmalignant pain: A dose-conversion and titration study. Int J Clin Pract. 2007; 61(10): 1671-1676.

Wallace M, Skowronski R, Khanna S, et al.: Efficacy and safety evaluation of once-daily Jurnista™ in patients with chronic low back pain: A pilot open label study (DO-127). Curr Med Res Opin. 2007; 23: 981-989.

Wallace M, Rauck RL, Moulin D, et al.: Conversion from standard opioid therapy to once-daily oral extended-release hydromorphone in patients with chronic cancer pain. Int J Med Res. 2008; 36(2): 343-352.

Hale M, Tudor IC, Khanna S, et al.: Efficacy and tolerability of once-daily OROS hydromorphone and twice-daily extendedrelease oxycodone in patients with chronic, moderate to severe osteoarthritis pain: Results of a 6-week, randomized, openlabel, noninferiority analysis. Clin Ther. 2007; 29(5): 874-888.

Sabatowski R, Giesecke T: Pharmacotherapy of chronic, nontumour related pain. Efficacy, tolerability and patient benefit of an oral osmotic system with hydromorphone. MMW Fortschr Med. 2007; 149 (Suppl 3): 119-124.

Hanna M, Thipphawong J: A randomized, double-blind comparison of OROS® hydromorphone and controlled-release morphine for the control of chronic cancer pain. BMC Palliat Care. 2008; 7: 17.

Hanna M, Tuca A, Thipphawong J: An open-label, 1-year extension study of the long-term safety and efficacy of oncedaily OROS® hydromorphone in patients with chronic cancer pain. BMC Palliat Care. 2009; 8: 14.

Yang M, Dubois D, Kosinski M, et al.: Mapping MOS Sleep Scale scores to SF-6D utility index. Curr Med Res Opin. 2007; 23(9): 2269-2282.

Greiner W, Lehmann K, Earnshaw S, et al.: Economic evaluation of Durogesic in moderate to severe, nonmalignant, chronic pain in Germany. Eur J Health Econ. 2006; 7(4): 290-296.

Johnson and Johnson Pharmaceutical Research and Development: OROS® Hydromorphone, Integrated Safety Review (Data on File). Johnson and Johnson Pharmaceuticals, 2006.

Walters SJ, Brazier JE: Comparison of the minimally important difference for two health state utility measures: EQ-5D and SF-6D. Qual Life Res. 2005; 14(6): 1523-1532.

Ward A, Bozkava D, Fleischmann J, et al.: Modeling the economic and health consequences of managing chronic osteoarthritis pain with opioids in Germany: Comparison of extended-release oxycodone and OROS hydromorphone. Curr Med Res Opin. 2007; 23(10): 2333-2345.

Frei A, Andersen S, Hole P, et al.: A one year health economic model comparing transdermal fentanyl with sustainedrelease morphine in the treatment of chronic noncancer pain. J Pain Palliat Care Pharmcother. 2003; 17(2): 5-26.




DOI: https://doi.org/10.5055/jom.2011.0070

Refbacks

  • There are currently no refbacks.