A cost-consequence analysis of parecoxib and opioids vs opioids alone for postoperative pain: Chinese perspective

Abstract

Purpose

The use of parecoxib plus opioids for postoperative analgesia in noncardiac surgical patients seems to be cost-saving in Europe due to a reduction in opioid use and opioid-related adverse events. Given the lack of information on postoperative analgesic use in Asia, this study assessed the economic consequences of the addition of parecoxib to opioids vs opioids alone to treat postsurgical pain in China.

Methods

A cost-consequence economic evaluation assessed direct medical costs related to opioid-related clinically meaningful events (CMEs) utilizing dosing information and reported frequency of events from a Phase III, randomized, double-blind, global clinical trial (PARA-0505-069) of parecoxib plus opioids vs opioids alone for 3 days following major orthopedic, abdominal, gynecologic, or noncardiac thoracic surgery requiring general or regional anesthesia. The cost of CMEs was calculated using information on resource utilization and unit costs provided by a panel of clinical experts in China. Sensitivity analyses were performed to test the robustness of the results.

Results

Patients treated with parecoxib plus opioids reported fewer CMEs (mean 0.62 vs 1.04 events per patient [P<0.0001]) compared with opioids alone for the 3-day postoperative period. This suggested a potential savings of 356 Chinese yuan (¥) per patient over the 3 days (total cost of ¥1,418 for parecoxib plus opioids vs ¥1,774 with opioid use alone).

Conclusion

Fewer CMEs with parecoxib plus opioids suggest a reduction in medical resource utilization and reduced costs compared to opioids alone when modeling analgesic use in non-cardiac surgery patients in China.

Keywords:

• multimodal analgesia
• parecoxib
• opioids
• treatment costs

Acknowledgments

This study was funded by Pfizer Inc. We would like to acknowledge the help of Ms Yuxin Li, who conducted the clinician interviews and translated the resource use questionnaires into Chinese and the answers into English.

Author contributions

All authors contributed to data analysis, drafting and revising the article, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

Disclosure

LA, ABS, and DDL are employees and shareholders of Pfizer Ltd, Pfizer Inc, and Pfizer Investment Co., Ltd., respectively. LX was an employee and shareholder of Pfizer Investment Co., Ltd. at the time of the study. ER and MB were employees of Evidera at the time of the study, who were paid consultants to Pfizer Inc in connection with the development of this manuscript. The authors report no other conflicts of interest in this work.