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Study: Incorporation of opioids not cost-effective for treatment of knee OA
Incorporation of opioids into treatment for knee osteoarthritis did not appear to be cost-effective due to a negative impact on pain relief from these medications after total knee arthroplasty, according to results.
Using the Osteoarthritis Policy model, researchers evaluated long-term clinical and economic outcomes of patients with knee osteoarthritis (OA) with persistent pain despite conservative treatment. Strategies evaluated included opioid-sparing, tramadol and tramadol followed by oxycodone treatments, according to researchers.
Results showed the tramadol strategy delayed total knee arthroplasty (TKA) by 7 years and led to reduction in TKA utilization by 4%, while the tramadol plus oxycodone strategy delayed TKA by 9 years and led to reduction in TKA utilization by 10%. Compared to the opioid-sparing strategy, researchers found both tramadol and tramadol plus oxycodone strategies increased cost and decreased quality-adjusted life years. According to results, the incremental cost-effectiveness ratios (ICERs) for tramadol was highly sensitive to its effect on TKA outcomes. Researchers found an ICER for tramadol strategy of $110,600 per quality-adjusted life years with reduction in TKA effectiveness by 5% compared to a base case of 10%, while the ICER was $26,900 per quality-adjusted life years with no reduction in TKA effectiveness. Results showed the ICER for tramadol was $39,600 per quality-adjusted life years when TKA was not considered a treatment option. – by Casey Tingle
Disclosures: Smith reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.