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A Journal on Internal Medicine and Pharmacology

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Gazzetta Medica Italiana Archivio per le Scienze Mediche 2013 November;172(11):835-44

language: English

Cost-consequence analysis of adjunctive use of the COX-2 inhibitor parecoxib compared to opioids alone after non-cardiac surgery in the United Kingdom

Muszbek N. 1, Choy A. 2, Remak E. 1, Manson S. C. 1, Chen C. 3, Zlateva G. 3, Langford R. M. 4

1 Health Economics, United BioSource Corporation, London UK;
2 General Surgery, Peterborough District Hospital, Peterborough, UK;
3 Global Outcomes Research Department, Pfizer Inc. New York, NY, USA;
4 Anesthetics Department, St. Bartholomew’s Hospital, London, UK


Aim: Opioid-sparing multimodal pain therapies have been introduced for postoperative pain relief, to reduce the adverse events associated with opioid treatment. This study aimed to assess the impact on health care resource utilisation and patient outcomes of adjunctive use of the opioid-sparing treatment parecoxib, compared with opioids alone, following non-cardiac surgery in the United Kingdom.
Methods: A model was developed to compare parecoxib plus opioid treatment to opioids alone during the first three days post-surgery, based on a Phase III randomised, double-blind clinical trial. Resource use associated with clinically meaningful opioid-related adverse events was elicited by means of a physician survey. Unit costs were obtained from publicly available sources from the perspective of the UK National Health Service. Effectiveness was expressed in terms of the summed pain intensity (SPI) score.
Results: Postoperative patients treated with parecoxib experienced less pain (SPI 59.14 vs. 80.64 over three days). The cost of parecoxib use over three days was an average of £14.22 per patient, and offset by a potential saving of £563 attributable to the reduction in CMEs and opioid use, resulting in a net saving of £555 (95% CI: £254-1,008). This saving was achieved by reductions of 1.24 days in the duration of hospital stay, and 0.36 and 1.57 hours in physician and nurse time, respectively. Even greater savings (£752) could be observed over the first five Postoperative days.
Conclusion: Parecoxib is a useful adjunct to opioids for analgesia following non-cardiac surgery, improving Postoperative pain relief and lowering overall treatment costs.

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