IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0179523.html
   My bibliography  Save this article

Cost-effectiveness analysis of oral fentanyl formulations for breakthrough cancer pain treatment

Author

Listed:
  • Paolo Angelo Cortesi
  • Lucia Sara D’Angiolella
  • Renato Vellucci
  • Massimo Allegri
  • Giuseppe Casale
  • Carlo Favaretti
  • Flavia Kheiraoui
  • Giancarlo Cesana
  • Lorenzo Giovanni Mantovani

Abstract

Breakthrough cancer Pain (BTcP) has a high prevalence in cancer population. Patients with BTcP reported relevant health care costs and poor quality of life. The study assessed the cost-effectiveness of the available Oral Fentanyl Formulations (OFFs) for BTcP in Italy. A decision-analytical model was developed to estimate costs and benefits associated with treatments, from the Italian NHS perspective. Expected reductions in pain intensity per BTcP episodes were translated into, percentage of BTcP reduction, resource use and Quality-Adjusted-Life-Years (QALYs). Relative efficacy, resources used and unit costs data were derived from the literature and validated by clinical experts. Probabilistic and deterministic sensitivity analyses were performed. At base-case analysis, Sublingual Fentanyl Citrate (FCSL) compared to other oral formulations reported a lower patient’s cost (€1,960.8) and a higher efficacy (18.7% of BTcP avoided and 0.0507 QALYs gained). The sensitivity analyses confirmed the main results in all tested scenarios, with the highest impact reported by BTcP duration and health care resources consumption parameters. Between OFFs, FCSL is the cost-effective option due to faster reduction of pain intensity. However, new research is needed to better understand the economic and epidemiologic impact of BTcP, and to collect more robust data on economic and quality of life impact of the different fentanyl formulations.Different fentanyl formulations are available to manage BTcP in cancer population. The study is the first that assesses the different impact in terms of cost and effectiveness of OFFs, providing new information to better allocate the resources available to treat BTcP and highlighting the need of better data.

Suggested Citation

  • Paolo Angelo Cortesi & Lucia Sara D’Angiolella & Renato Vellucci & Massimo Allegri & Giuseppe Casale & Carlo Favaretti & Flavia Kheiraoui & Giancarlo Cesana & Lorenzo Giovanni Mantovani, 2017. "Cost-effectiveness analysis of oral fentanyl formulations for breakthrough cancer pain treatment," PLOS ONE, Public Library of Science, vol. 12(6), pages 1-13, June.
    • Handle: RePEc:plo:pone00:0179523
    DOI: 10.1371/journal.pone.0179523
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0179523
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0179523&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0179523?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Torrance, George W., 1986. "Measurement of health state utilities for economic appraisal : A review," Journal of Health Economics, Elsevier, vol. 5(1), pages 1-30, March.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Hougaard, Jens Leth & Moreno-Ternero, Juan D. & Østerdal, Lars Peter, 2013. "A new axiomatic approach to the evaluation of population health," Journal of Health Economics, Elsevier, vol. 32(3), pages 515-523.
    2. McCabe, Christopher & Brazier, John & Gilks, Peter & Tsuchiya, Aki & Roberts, Jennifer & O'Hagan, Anthony & Stevens, Katherine, 2006. "Using rank data to estimate health state utility models," Journal of Health Economics, Elsevier, vol. 25(3), pages 418-431, May.
    3. David Mayston, "undated". "Developing a Framework Theory for Assessing the Benefits of Careers Guidance," Discussion Papers 02/08, Department of Economics, University of York.
    4. Islam, M. Kamrul & Gerdtham, Ulf-G. & Gullberg, Bo & Lindström, Martin & Merlo, Juan, 2008. "Social capital externalities and mortality in Sweden," Economics & Human Biology, Elsevier, vol. 6(1), pages 19-42, March.
    5. Mark Sculpher & Amiram Gafni, 2001. "Recognizing diversity in public preferences: The use of preference sub‐groups in cost‐effectiveness analysis," Health Economics, John Wiley & Sons, Ltd., vol. 10(4), pages 317-324, June.
    6. Oliver, Adam, 2003. "The internal consistency of the standard gamble: tests after adjusting for prospect theory," LSE Research Online Documents on Economics 159, London School of Economics and Political Science, LSE Library.
    7. Kevin Haninger & James K. Hammitt, 2011. "Diminishing Willingness to Pay per Quality‐Adjusted Life Year: Valuing Acute Foodborne Illness," Risk Analysis, John Wiley & Sons, vol. 31(9), pages 1363-1380, September.
    8. Louis S. Matza & Katherine J. Kim & Holly Yu & Katherine A. Belden & Antonia F. Chen & Mark Kurd & Bruce Y. Lee & Jason Webb, 2019. "Health state utilities associated with post-surgical Staphylococcus aureus infections," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(6), pages 819-827, August.
    9. Stirling Bryan & David Parry, 2002. "Structural reliability of conjoint measurement in health care: an empirical investigation," Applied Economics, Taylor & Francis Journals, vol. 34(5), pages 561-567.
    10. Blumenschein, Karen & Johannesson, Magnus, 1998. "An experimental test of question framing in health state utility assessment," Health Policy, Elsevier, vol. 45(3), pages 187-193, September.
    11. Attema, Arthur E. & Brouwer, Werner B.F., 2013. "In search of a preferred preference elicitation method: A test of the internal consistency of choice and matching tasks," Journal of Economic Psychology, Elsevier, vol. 39(C), pages 126-140.
    12. Paul Hanly & Rebecca Maguire & Frances Drummond & Linda Sharp, 2019. "Variation in the methodological approach to productivity cost valuation: the case of prostate cancer," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(9), pages 1399-1408, December.
    13. MORENO-TERNERO, Juan & OSTERDAL, Lars P., 2014. "Normative foundations for equity-sensitive population health evaluation functions," LIDAM Discussion Papers CORE 2014031, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
    14. Anne Spencer, 2001. "The Implications of Linking Questions within the SG and TTO Methods," Working Papers 438, Queen Mary University of London, School of Economics and Finance.
    15. José-Luis Pinto-Prades & José-María Abellán-Perpiñán, 2004. "Mesuring the Health of Populations: The Veil of Ignorance Approach," Working Papers 116, Barcelona School of Economics.
    16. Herrera-Araujo, Daniel & Hammitt, James K. & Rheinberger, Christoph M., 2020. "Theoretical bounds on the value of improved health," Journal of Health Economics, Elsevier, vol. 72(C).
    17. Johanna Cook & Jeff Richardson & Andrew Street, 1994. "A cost utility analysis of treatment options for gallstone disease: Methodological issues and results," Health Economics, John Wiley & Sons, Ltd., vol. 3(3), pages 157-168, May.
    18. Karen Gerard & Gavin Mooney, 1993. "Qaly league tables: Handle with care," Health Economics, John Wiley & Sons, Ltd., vol. 2(1), pages 59-64, April.
    19. Gerdtham, U. -G. & Johannesson, M. & Lundberg, L. & Isacson, D., 1999. "The demand for health: results from new measures of health capital," European Journal of Political Economy, Elsevier, vol. 15(3), pages 501-521, September.
    20. Mark Sculpher & David Torgerson & Ron Goeree & Bernie O'Brien, 1999. "A critical structured review of economic evaluations of interventions for the prevention and treatment of osteoporosis," Working Papers 169chedp, Centre for Health Economics, University of York.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0179523. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.