Disability-adjusted life expectancy lost due to pain severity and usual analgesic treatment among older adults with osteoarthritis in Spain

Llopart-Carles, Natalia; García-López, Sofía; Rejas‐Gutiérrez, Javier

doi:10.1007/s40520-020-01630-z

Cited by 6 publications

(3 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Osteoarthritis (OA), the most common form of arthritis of the knee, causes pain, joint stiffness and functional limitation, decreases the quality of life, and increases the mortality risk of many patients worldwide [ 1 , 2 ]. The current treatment of OA should include a combination of pharmacological and non-pharmacological therapies as recommended in the update of the guidelines of the Osteoarthritis Research Society International (OARSI) [ 3 ] and the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Health Economic Evaluation of a High and Low Molecular Weight Hyaluronic Acid Formulation for the Treatment of Knee Osteoarthritis. Post Hoc Analyses from a Randomized Clinical Trial

2022

View full text Add to dashboard Cite

Introduction In a recent randomized placebo-controlled trial, a single intra-articular injection of a high and low molecular weight hyaluronic acid formulation (HA–HL) was shown to be effective in providing a clinically meaningful reduction in pain and functional limitation up to 24 weeks in subjects with painful knee osteoarthritis (OA). The objective of this post hoc analyses is to assess the cost-effectiveness of HA–HL compared with placebo using individual patient data from this clinical trial in a Swiss health care perspective. Methods A total of 692 patients fulfilling the inclusion criteria were randomly allocated to HA–HL or placebo groups. Each patient received one intra-articular injection of HA–HL or placebo at baseline and was then followed-up for a total duration of 24 weeks with five follow-up visits (i.e., after weeks 1, 6, 12, 18, and 24). The EQ-5D-5L five-point verbal Likert scale was used to calculate the health utility and the related quality-adjusted life-years (QALYs) using the area-under-the-curve (AUC) method. For the costs, the price of HA-HL in Switzerland was used. The primary threshold for the incremental cost/effectiveness ratio (ICER) below which HA-HL was considered as cost-effective was 91,540 Swiss francs (CHF) per QALY (i.e., US $100,000). Results No significant difference between the baseline characteristics of the HA–HL group and the placebo group was observed. With a mean ICER of 27,212 CHF per QALY (95% CI 20,135–34,289), HA–HL was considered as cost-effective compared to placebo. Sensitivity analyses (e.g., using lower or upper limit prices or using other threshold values) gave similar results, i.e., ICERs far below the threshold values of cost-effectiveness. Conclusions These results confirm the role of HA–HL as a cost-effective therapeutic option in the management of OA. However, more studies taking into account the utilization of other health care resources are needed.

show abstract

Section: Introductionmentioning

confidence: 99%

Health Economic Evaluation of a High and Low Molecular Weight Hyaluronic Acid Formulation for the Treatment of Knee Osteoarthritis. Post Hoc Analyses from a Randomized Clinical Trial

2022

View full text Add to dashboard Cite

show abstract

“…22 Using data from the 2017 SNHS, it has been estimated that chronic OA pain is a considerable source of burden to society and the health system; on average, patients with OA lost 35.6% of their life expectancy due to disability (Disability-Adjusted-Life-Expectancy loss of 3.5 years per patient). 23 Likewise, OA exerts a significant impact on healthcare systems, given the substantial costs associated with joint replacement surgery, specialist consultation and the use of prescription medicines, amongst other resources, to manage moderate to severe pain. [19][20][21]24 In Spain, OA healthcare costs were on average €2274 per patient per year; projecting the actual prevalence of OA, 15 the actual national costs would be €11.2bn, or 0.96% of the 2017 Spanish gross domestic product.…”

Section: Introductionmentioning

confidence: 99%

Future projections of opioid use and cost in patients with chronic osteoarthritis pain in Spain

Rejas‐Gutiérrez

Sicras‐Mainar²,

Darbà

2021

Therapeutic Advances in Musculoskeletal

Self Cite

View full text Add to dashboard Cite

Background: Opioids are widely used in moderate-to-severe chronic pain which is non-responsive to standard analgesics. Prescriptions have increased in Europe in the last decade, although remain lower than in USA. This work projected the future utilization and costs of opioids in chronic osteoarthritis (OA) pain in the Spanish National Health System (NHS). Methods: An epidemiological model was populated with the opioid dispensing trends from 2010 to 2019 using Spanish Medicinal Agency rates of opioid utilization in subjects over 18 years of age and the real-world OPIOIDS study to estimate chronic-OA-pain patients receiving opioids. A best-fitted trend analysis model was applied estimating the likely number of DHD (defined daily dose/1000 inhabitants per day) to calculate projected opioid utilization and costs for the period 2020–2029. Results: In 2010, an estimated 5.67 DHD were dispensed for the equivalent of 217,076 chronic OA pain patients per day [1.99 DHD, 76,084 refractory to non-steroidal anti-inflammatory drugs (NSAIDs)]. From these trends and OA prevalence, the projected number of DHDs is expected to increase more than threefold to 17.98 DHDs by the year 2029 for the equivalent of 727,356 chronic OA pain patients per day (8.18 DHD, 330,720 refractory to NSAIDs); 41.8% on strong opioids. The estimated cost was €116.9m (€45.0m in NSAID-refractory OA) in 2010 rising by 222% to €376.1m (€199.7m refractory to NSAIDs) by 2029. Conclusion: Chronic-OA-pain-related opioid dispensing and costs to the NHS are set to increase more than threefold from 2010 to 2029 in Spain. Using opioids for OA pain is concerning given disease chronicity and other related costs not computed in these projections. Plain language summary • Opioids are widely used in chronic pain which is non-responsive to standard analgesics. Prescriptions have increased in Europe, although remain lower than in USA. Osteoarthritis (OA) is a degenerative joint disease usually accompanied by pain. Despite not recommended, opioids use in OA have been expanded because this health condition is increasing with ageing and, also, because physicians both primary and specialist boosted their use. • This study aimed to quantify the current burden of opioids used for chronic moderate-to-severe OA pain by estimating the number of defined daily doses per 1000 inhabitants per day (DHD) and associated costs, and to forecast the likely burden on the National Health System (NHS) in Spain for the years 2020–2029. • In 2010, an estimated 5.67 DHDs were dispensed for the equivalent of 217,076 chronic OA pain patients per day. From these trends, the projected number of DHDs is expected to increase more than threefold to 17.98 DHDs by the year 2029 for the equivalent of 727,356 chronic OA pain patients per day; 41.8% on strong opioids. The estimated cost was €116.9m in 2010 rising by 222% to €376.1m by 2029. • Chronic OA-pain-related opioid dispensing and costs to the NHS are set to increase substantially (threefold to more than fourfold) from 2010 to 2029 in Spain. Thus, using opioids for OA pain is concerning given disease chronicity, aging population and other related costs not computed in these projections. Our findings can inform payors and clinicians about ongoing discussions on appropriate analgesic management for longer-term OA pain, including resource requirements at a national level. Clinicians who prescribe opioids for OA pain should consider the potential implications of side effects such as sedation, cognitive deterioration, incremental need of caregivers, particularly in older people, and carefully consider the risk–benefit balance.

show abstract

“…In Spain, according to most recent epidemiologic studies, OA in any location affects up to 29.4% of people aged 40 or older 5 , with pain as a core symptom in many patients 6,7 : up to 56.5% of OA patients suffered from moderate to severe pain in last four weeks, according to the 2017 Spanish National Health Survey (ENSE) 8,9 . The disease may have a commensurate tremendous individual and socioeconomic burden 1,4,[10][11][12][13][14][15][16][17] , and as it is usually accompanied by pain, it is a significant cause of burden to society, both from a humanistic point of view (contributing to poor quality of life) and in economic terms (impacting the limited healthcare budgets of national health systems) 10 .…”

Section: Introductionmentioning

confidence: 99%

Disease burden on health care by pain severity and usual analgesic treatment in patients with symptomatic osteoarthritis: a Spanish nationwide health survey

Rejas‐Gutiérrez

Llopart-Carles

García-López

et al. 2020

Expert Review of Pharmacoeconomics & Outcomes Research

Self Cite

View full text Add to dashboard Cite

Objectives: To estimate disease burden on healthcare in osteoarthritis (OA) pain patients in Spain, and to determine whether frequency of healthcare resource utilisation (HRU) and related costs differ by pain severity and treatment with usual analgesics. Methods:The 2017 Spanish National Health Survey (ENSE), a large, nationwide, cross-sectional general health survey, was used to abstract data on adult patients with a self-reported physician diagnosis of OA. Patients were cross-classified according to pain severity in the last 4-weeks (no/mild, moderate, severe) and use of usual analgesia in the last 2-weeks (treated/untreated). Per patient per year (PPPY) HRU included medical visits, other healthcare visits, diagnostic/laboratory tests, days of hospitalisation, days in day hospital facilities, and surgical procedures. Costs were computed by multiplying unit price by annual frequency of HRU.Results: 5,234 OA patients were analysed (women 70.8%; age 69.9 [SD:13.1]; 66.5% treated). Significant associations were observed in treated and untreated OA patients between pain severity and adjusted PPPY mean utilisation of medical visits, days of hospitalisation, other healthcare visits, and related costs: the greater the pain severity, the greater the HRU and costs, with treated showing higher HRU and costs than untreated patients. Average total healthcare costs were €2,274 (5,461) PPPY, with costs associated with outpatient healthcare visits being the major driver.Conclusions: HRU and related costs were seen to increase as pain severity increased in patients with OA in a nationally representative sample in Spain. These findings seem to be more consistent in treated versus not treated patients with usual analgesics.

show abstract

Disability-adjusted life expectancy lost due to pain severity and usual analgesic treatment among older adults with osteoarthritis in Spain

Cited by 6 publications

References 31 publications

Health Economic Evaluation of a High and Low Molecular Weight Hyaluronic Acid Formulation for the Treatment of Knee Osteoarthritis. Post Hoc Analyses from a Randomized Clinical Trial

Health Economic Evaluation of a High and Low Molecular Weight Hyaluronic Acid Formulation for the Treatment of Knee Osteoarthritis. Post Hoc Analyses from a Randomized Clinical Trial

Future projections of opioid use and cost in patients with chronic osteoarthritis pain in Spain

Disease burden on health care by pain severity and usual analgesic treatment in patients with symptomatic osteoarthritis: a Spanish nationwide health survey

Contact Info

Product

Resources

About