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Cost-Effectiveness Analysis of the Treatment Strategies with or without Opioid Medications in Surgery-Eligible Patients with Osteoarthritis in Japan

Author

Listed:
  • Tomoyuki Takura

    (The University of Tokyo)

  • Akira Yuasa

    (Pfizer Japan Inc.)

  • Naohiro Yonemoto

    (Pfizer Japan Inc.)

  • Sven Demiya

    (IQVIA Solutions Japan K.K.)

  • Hiroyuki Matsuda

    (IQVIA Solutions Japan K.K.)

  • Nozomi Ebata

    (Pfizer Japan Inc)

  • Koichi Fujii

    (Pfizer Japan Inc)

  • Muneaki Ishijima

    (Juntendo University Graduate School of Medicine)

Abstract

Aim The aim of this study was to evaluate the cost effectiveness of treatment strategies without opioid medications (non-opioid treatment strategy) versus strategies with opioid medications (opioid treatment strategy) among surgery-eligible patients with osteoarthritis (OA) of the knee or hip in Japan. Materials and Methods We built a Markov cohort model to evaluate outcomes for the treatment strategies in surgery-eligible patients aged ≥ 65 years with OA of the knee or hip in Japan. The opioid treatment strategy as an intervention includes a health state with opioid medication in the treatment pathway. On the other hand, for the non-opioid treatment strategy, there is no health state with opioid medication. A targeted literature review and database analysis were conducted to identify and define the values of the variables included in the model. The time horizon was set to 30 years, and a 2% discount was applied for cost and quality-adjusted life-years (QALYs). Sensitivity analysis and scenario analysis were performed in the model. The outcomes were QALYs and the incremental cost-effectiveness ratio (ICER). Results In the base-case analysis, the non-opioid treatment strategy was dominant over the opioid treatment strategy and associated with an incremental cost and QALYs of − 53,878 JPY (− 499 USD) and 0.03 QALYs, respectively, in patients with knee OA, and − 54,129 JPY (− 502 USD) and 0.02 QALYs, respectively, in patients with hip OA. One-way sensitivity analysis showed the ICER was most sensitive to the QALY for opioid monotherapy. Probabilistic sensitivity analyses showed a high degree of uncertainty associated with the results. Limitations Study limitations included assumptions related to transition probabilities of the health states, and a lack of Japanese-specific data for transition probabilities, incidence of adverse events and utility values. Conclusions This study suggests that the non-opioid treatment strategy is cost effective compared with the opioid treatment strategy in the management of surgery-eligible patients with OA of the knee or hip. However, this final conclusion may not be accurate as the methodology is heavily reliant on assumptions.

Suggested Citation

  • Tomoyuki Takura & Akira Yuasa & Naohiro Yonemoto & Sven Demiya & Hiroyuki Matsuda & Nozomi Ebata & Koichi Fujii & Muneaki Ishijima, 2022. "Cost-Effectiveness Analysis of the Treatment Strategies with or without Opioid Medications in Surgery-Eligible Patients with Osteoarthritis in Japan," PharmacoEconomics - Open, Springer, vol. 6(1), pages 33-45, January.
    • Handle: RePEc:spr:pharmo:v:6:y:2022:i:1:d:10.1007_s41669-021-00292-5
    DOI: 10.1007/s41669-021-00292-5
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    References listed on IDEAS

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    1. Briggs, Andrew & Sculpher, Mark & Claxton, Karl, 2006. "Decision Modelling for Health Economic Evaluation," OUP Catalogue, Oxford University Press, number 9780198526629.
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