Cost/effectiveness evaluation of three fixed combinations of acetaminophen and opioids in the management of acute pain in Colombia

  • Rafael Alfonso Cristancho a. RANDOM Foundation, Bogotá, Colombia. b. University of Washington, Seattle, USA
  • Andres I. Vecino a. RANDOM Foundation, Bogotá, Colombia. b. Johns Hopkins University-School of Public Health, Baltimore, USA
  • Juan Diego Misas Medical Department, Sanofi-Aventis, Bogotá, Colombia
Keywords: Economics, Pharmaceutical, Analgesics, Opioid, Acute Pain, Public Health, Colombia

Abstract

Objective: To compare the cost-effectiveness of three different formulations indicated for moderate and severe acute pain, commercialized in Colombia [acetaminophen 500 mg + codeine 30 mg (AC), acetaminophen 500 mg + hydrocodone 5 mg (AH) and acetaminophen 325 mg+ tramadol 37.5 mg (AT)].

Materials and methods:Cost-effectiveness analysis using the NNT as the health outcome indicator. The costs were evaluated in two specific settings: Institutional Channel (IC), representing the cost for the Colombian Ministry of Health (SISMED 2011); Retail Channel (RC), representing consumer prices, obtained from the IMS annual average for 2011, plus an adjustment to include the average profit margin for pharmacies (10%). The incremental cost effectiveness ratios (ICER) were calculated for the three formulations and the two settings (IC and RC). The intervention values are expressed in Colombian pesos (COP).

Results: The prices/NNT for each formulation were $1816 COP/2.2 for AC, $4772 COP/2.3 for AH and $5342/2.6 for AT. Using these data and taking AC as the comparator, the ICER for the other formulations shows the following results: in the RC, $5065 COP for AT and $19,600 COP for AH; in the IC setting, $8790 COP for AT and $29,460 COP for AH. The probabilistic sensitivity analysis demonstrated that the majority of simulation results fell between the 1st and 4th quadrants of the cost-effectiveness matrix, using AC as a reference.

Conclusion: The analysis, from the payer and patient perspectives, demonstrates that the AC formulation has a lower cost and is more effective inreducingpain within the first 4-6 h after administration, compared with the AH and AT formulations in their specific indications.

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How to Cite
1.
Cristancho RA, Vecino AI, Misas JD. Cost/effectiveness evaluation of three fixed combinations of acetaminophen and opioids in the management of acute pain in Colombia. Colomb. J. Anesthesiol. [Internet]. 2015Jan.1 [cited 2021May9];43(1):87 -94. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/489

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Published
2015-01-01
How to Cite
1.
Cristancho RA, Vecino AI, Misas JD. Cost/effectiveness evaluation of three fixed combinations of acetaminophen and opioids in the management of acute pain in Colombia. Colomb. J. Anesthesiol. [Internet]. 2015Jan.1 [cited 2021May9];43(1):87 -94. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/489
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