Economic evaluation of tramadol/paracetamol in the management of pain in patients with osteoarthritis in Spain

Objective: To compare the costs of treating osteoarthritis (OA) pain using combination tramadol/paracetamol tablets, Non-Steroidal Anti- Inflammatory Agents ( NSAID) alone or NSAID plus proton pump inhibitors (PPI) from the perspective of the Spanish National Health System. Methods: Adecision-analytical model was constructed to analyze the cost associated with three treatment strategies over 6 months. A cost-minimization approach was used, which considered data related to resource use, medication costs and costs for the treatment of adverse events. Results: In the base-case analysis, costs for 6 months of treatment of OA pain using tramadol/ paracetamol were (sic)232.86, compared with (sic)274.60 for NSAID + PPI and D 133.75 for NSAID alone. This provided a savings of D 41.74 per patient over 6 months for tramadol/ paracetamol compared with NSAID + PPI and a cost increase of D 99.11 compared with NSAID alone. When renal adverse events associated with NSAID were considered, tramadol/ paracetamol was cost saving compared with all NSAID-based regimens (saving (sic)140.02 vs NSAID alone, D 280.86 vs NSAID + PPI). Conclusion: Based on the results of a theoretical decision-analytic model, the data obtained may suggest that tramadol/ paracetamol is cost saving compared with NSAID + PPI for the treatment of OA pain over a period of 6 months. Tramadol/paracetamol is also cost saving compared with treatment with NSAID alone if considering renal adverse events. (C) 2010 Elsevier Espana, S.L. All rights reserved.