Economic evaluation of tramadol/paracetamol in the management of pain in patients with osteoarthritis in Spain
Evaluación económica de tramadol/paracetamol en el manejo del dolor en pacientes con osteoartrosis en España
Javier Vidala, Pere Benitob, Anna Manresac, Domingo Ly-Pend, Enrique Batllee, Francisco J. Blancof, Max Brosag, Diana Nievesg,
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diana.nieves@oblikue.com
Corresponding author. Oblikue Consulting, C/Josep Irla i Bosch, 5–7, 1.ª planta, 08034 Barcelona. Spain.
Corresponding author. Oblikue Consulting, C/Josep Irla i Bosch, 5–7, 1.ª planta, 08034 Barcelona. Spain.
a Servicio de Reumatología, Hospital General Universitario de Guadalajara, Guadalajara, Spain
b Servicio de Reumatología, Hospital del Mar-IMAS, Barcelona, Spain
c CAP Nou Tarraco, Tarragona, Spain
d Centro de Salud Gandhi, Madrid, Spain
e Servicio de Reumatología, Hospital General Universitario de Alicante, Alicante, Spain
f Servicio de Reumatología, Hospital Universitario A Coruña, A Coruña, Spain
g Oblikue Consulting, Barcelona, Spain
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Oblikue Consulting, C/Josep Irla i Bosch, 5–7, 1.ª planta, 08034 Barcelona. Spain." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Evaluación económica de tramadol/paracetamol en el manejo del dolor en pacientes con osteoartrosis en España" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2010-09-14" "fechaAceptado" => "2010-11-29" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec112785" "palabras" => array:4 [ 0 => "Cost-minimisation analysis" 1 => "Tramadol/paracetamol" 2 => "Non-Steroidal Anti-Inflammatory Agents" 3 => "Osteoarthritis" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec112786" "palabras" => array:4 [ 0 => "Análisis de minimización de costes" 1 => "Tramadol/paracetamol" 2 => "Antiinflamatorios no esteroideos" 3 => "Osteoartrosis" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">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.</p> <span class="elsevierStyleSectionTitle">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">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.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">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).</p> <span class="elsevierStyleSectionTitle">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">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</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">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.</p> <span class="elsevierStyleSectionTitle">Métodos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">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 (AE) de la medicación.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">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 AE 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).</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">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 AE renales.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:36 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Encuesta Nacional de Salud de España, 2006. 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| Year/Month | Html | Total | |
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| 2023 September | 31 | 46 | 77 |
| 2023 August | 18 | 18 | 36 |
| 2023 July | 24 | 19 | 43 |
| 2023 June | 16 | 25 | 41 |
| 2023 May | 13 | 15 | 28 |
| 2023 April | 20 | 9 | 29 |
| 2023 March | 27 | 30 | 57 |
| 2023 February | 27 | 32 | 59 |
| 2023 January | 19 | 22 | 41 |
| 2022 December | 36 | 40 | 76 |
| 2022 November | 34 | 38 | 72 |
| 2022 October | 19 | 32 | 51 |
| 2022 September | 42 | 33 | 75 |
| 2022 August | 54 | 51 | 105 |
| 2022 July | 39 | 46 | 85 |
| 2022 June | 66 | 37 | 103 |
| 2022 May | 33 | 55 | 88 |
| 2022 April | 48 | 64 | 112 |
| 2022 March | 38 | 77 | 115 |
| 2022 February | 32 | 44 | 76 |
| 2022 January | 12 | 41 | 53 |
| 2021 December | 28 | 45 | 73 |
| 2021 November | 26 | 59 | 85 |
| 2021 October | 23 | 57 | 80 |
| 2021 September | 15 | 43 | 58 |
| 2021 August | 24 | 64 | 88 |
| 2021 July | 21 | 34 | 55 |
| 2021 June | 24 | 53 | 77 |
| 2021 May | 32 | 50 | 82 |
| 2021 April | 65 | 117 | 182 |
| 2021 March | 50 | 37 | 87 |
| 2021 February | 32 | 27 | 59 |
| 2021 January | 30 | 23 | 53 |
| 2020 December | 17 | 24 | 41 |
| 2020 November | 74 | 13 | 87 |
| 2020 October | 32 | 15 | 47 |
| 2020 September | 25 | 30 | 55 |
| 2020 August | 24 | 35 | 59 |
| 2020 July | 14 | 24 | 38 |
| 2020 June | 24 | 34 | 58 |
| 2020 May | 23 | 15 | 38 |
| 2020 April | 20 | 15 | 35 |
| 2020 March | 20 | 12 | 32 |
| 2020 February | 1 | 0 | 1 |
| 2020 January | 10 | 0 | 10 |
| 2019 September | 4 | 0 | 4 |
| 2019 June | 2 | 0 | 2 |
| 2019 March | 2 | 0 | 2 |
| 2019 January | 1 | 0 | 1 |
| 2018 May | 5 | 2 | 7 |
| 2018 April | 34 | 17 | 51 |
| 2018 March | 45 | 23 | 68 |
| 2018 February | 50 | 6 | 56 |
| 2018 January | 18 | 10 | 28 |
| 2017 December | 37 | 10 | 47 |
| 2017 November | 15 | 15 | 30 |
| 2017 October | 26 | 8 | 34 |
| 2017 September | 12 | 17 | 29 |
| 2017 August | 11 | 15 | 26 |
| 2017 July | 9 | 11 | 20 |
| 2017 June | 22 | 16 | 38 |
| 2017 May | 13 | 21 | 34 |
| 2017 April | 19 | 14 | 33 |
| 2017 March | 13 | 16 | 29 |
| 2017 February | 9 | 12 | 21 |
| 2017 January | 13 | 8 | 21 |
| 2016 December | 45 | 13 | 58 |
| 2016 November | 21 | 8 | 29 |
| 2016 October | 35 | 11 | 46 |
| 2016 September | 33 | 14 | 47 |
| 2016 August | 33 | 18 | 51 |
| 2016 July | 17 | 14 | 31 |
| 2016 June | 0 | 17 | 17 |
| 2016 May | 0 | 17 | 17 |
| 2016 April | 1 | 13 | 14 |
| 2016 March | 0 | 13 | 13 |
| 2016 February | 2 | 10 | 12 |
| 2016 January | 2 | 0 | 2 |
| 2015 December | 2 | 0 | 2 |
| 2015 October | 0 | 14 | 14 |
| 2015 September | 2 | 0 | 2 |
| 2015 August | 3 | 13 | 16 |
| 2015 July | 12 | 7 | 19 |
| 2015 June | 22 | 22 | 44 |
| 2015 May | 44 | 31 | 75 |
| 2015 April | 25 | 25 | 50 |
| 2015 March | 16 | 28 | 44 |
| 2015 February | 30 | 21 | 51 |
| 2015 January | 34 | 25 | 59 |
| 2014 December | 33 | 34 | 67 |
| 2014 November | 26 | 22 | 48 |
| 2014 October | 13 | 33 | 46 |
| 2014 September | 16 | 22 | 38 |
| 2014 August | 26 | 31 | 57 |
| 2014 July | 16 | 33 | 49 |
| 2014 June | 47 | 29 | 76 |
| 2014 May | 37 | 24 | 61 |
| 2014 April | 44 | 41 | 85 |
| 2014 March | 50 | 36 | 86 |
| 2014 February | 43 | 22 | 65 |
| 2014 January | 39 | 29 | 68 |
| 2013 December | 31 | 10 | 41 |
| 2013 November | 21 | 20 | 41 |
| 2013 October | 44 | 19 | 63 |
| 2013 September | 34 | 21 | 55 |
| 2013 August | 42 | 28 | 70 |
| 2013 July | 27 | 30 | 57 |
| 2013 June | 30 | 27 | 57 |
| 2013 May | 34 | 18 | 52 |
| 2013 April | 27 | 35 | 62 |
| 2013 March | 22 | 47 | 69 |
| 2013 February | 26 | 24 | 50 |
| 2013 January | 17 | 17 | 34 |
| 2012 December | 17 | 17 | 34 |
| 2012 November | 19 | 20 | 39 |
| 2012 October | 5 | 23 | 28 |
| 2012 September | 6 | 6 | 12 |
| 2012 July | 1 | 0 | 1 |
| 2012 June | 2 | 0 | 2 |
| 2012 May | 1 | 0 | 1 |
| 2012 April | 6 | 0 | 6 |
| 2012 March | 5 | 0 | 5 |
| 2012 February | 4 | 0 | 4 |
| 2011 December | 11 | 0 | 11 |
| 2011 November | 5 | 0 | 5 |
| 2011 October | 2 | 0 | 2 |
| 2011 September | 2 | 0 | 2 |
| 2011 August | 1 | 0 | 1 |
| 2011 July | 5 | 0 | 5 |
Show all
