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Análisis de impacto presupuestario del uso de fentanilo intranasal en pectina para el tratamiento del dolor irruptivo oncológico

  • Artículo de Investigación Original
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PharmacoEconomics Spanish Research Articles

Resumen

Introducción

El objetivo fue estimar los ahorros potenciales derivados de la introducción progresiva del fentanilo intranasal en pectina (PecFent®) en el tratamiento de pacientes mayores de edad con dolor irruptivo oncológico, desde la perspectiva del Sistema Sanitario Español.

Métodos

Se desarrolló un análisis de impacto presupuestario a un año para estimar el coste total por año, por paciente y por episodio, de la administración de los diferentes fentanilos comercializados hasta el momento del análisis. Los datos se obtuvieron de distintas fuentes de literatura y de un panel de 10 expertos. Se consideraron los costes médicos directos de la medicación y los ajustes de dosis, la medicación de rescate y las visitas médicas necesarias. Los costes se expresaron en euros del año 2011. Se realizaron múltiples análisis de sensibilidad univariados.

Resultados

La introducción progresiva de fentanilo intranasal en pectina en el arsenal terapéutico disponible para el tratamiento de los episodios de dolor irruptivo oncológico permite ahorros anuales de 681.020 € en España, considerando únicamente la sustitución por fentanilo intranasal en pectina de un 2,5 % de las actuales formulaciones de otros fentanilos. Los ahorros anuales por episodio y por paciente serían, respectivamente, de 25,42 € y 9,36 €. Los análisis de sensibilidad demostraron que los resultados fueron robustos, y hubo mayores ahorros en aquellos escenarios en los que hay un mayor número de episodios tratados con fentanilo intranasal en pectina (los ahorros anuales oscilarían entre 184.934 € y 15.723.443 €).

Conclusión

Debido al perfil farmacocinético y a la posología de fentanilo intranasal en pectina, los pacientes con este tratamiento supondrán una menor carga económica para el Sistema Sanitario Español, principalmente por el menor consumo de recursos sanitarios que precisarán.

Abstract

Introduction

The objective was to estimate the potential savings related to the progressive introduction of fentanyl pectin nasal spray (PecFent®) for the treatment of adult population with breakthrough cancer pain for the Spanish health care system.

Methods

A one year budget impact model analysis was developed to estimate the total cost per year, per patient and per episode, for the different fentanyl formulations available. Data source was a literature review and a panel of 10 experts. Direct medical costs were considered in the analysis (medication, dose adjustment, rescue medication and medical visits costs). Costs were expressed in 2011 euros. Several univariate sensitivity analyses were performed.

Results

The progressive introduction of fentanyl pectin nasal spray as a therapeutic option for the treatment of breakthrough cancer pain episodes showed savings to the Spanish healthcare system amounting to € 681,020, when considering a substitution of just a 2.5 % of the current fentanyl prescriptions. Yearly savings per episode and per patient were € 25.42 and € 9.36, respectively. The sensitivity analyses demonstrated the robustness of the results, with higher savings in scenarios with a higher number of episodes treated with fentanyl pectin nasal spray (yearly savings would range from € 184,934 to € 15,723,443).

Conclusions

Due to the pharmacokinetics and to the dosage, the treatment with fentanyl pectin nasal spray would result in a lower economic burden for the Spanish health system, mainly because of the lower health resource utilization for these patients.

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Agradecimientos

Financiación y conflicto de intereses

El presente trabajo ha sido financiado por Archimedes Pharma.

Los autores declaran no tener ningún ningún conflicto de intereses pertinente al contexto de este estudio.

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Authors and Affiliations

  1. Servicio de Oncología Médica del Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, España

    Rafael López

  2. Servicio de Oncología Médica del Hospital Universitario de Salamanca, Salamanca, España

    Juan Jesús Cruz

  3. Unidad del Dolor del Hospital Virgen de las Nieves, Granada, España

    Rafael Gálvez

  4. Servicio de Oncología Médica del Hospital Universitario Gregorio Marañón, Madrid, España

    Yolanda Escobar

  5. Servicio de Cuidados Paliativos Institut Català d’Oncologia, Badalona, España

    Joaquim Juliá

  6. Servicio de Oncología Radioterápica del Hospital Universitario La Paz, Madrid, España

    Ana Mañas

  7. Departamento de Farmacología de la Universidad de Alcalá de Henares, Madrid, España

    Francisco Zaragozá

  8. Servicio de Anestesiología, Reanimación y Terapéutica del Dolor del Hospital General Universitario de Alicante, Alicante, España

    Cesar Margarit

  9. Servicio de Oncología Médica del Hospital Virgen del Rocío, Sevilla, España

    Ana Casas

  10. Servicio de Oncología Médica del Hospital Universitario Miguel Servet, Zaragoza, España

    Antonio Antón

  11. Archimedes Pharma Ibérica, S.L. Av Europa, 16 Chalet 4. Pozuelo de Alarcón, 28224, Madrid, España

    Yolanda Riesgo

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  1. Rafael López
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Correspondence to Yolanda Riesgo.

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López, R., Cruz, J.J., Gálvez, R. et al. Análisis de impacto presupuestario del uso de fentanilo intranasal en pectina para el tratamiento del dolor irruptivo oncológico. PharmacoEcon Span Res Artic 11, 51–60 (2014). https://doi.org/10.1007/s40277-013-0018-3

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