A US Retrospective Claims Analysis Comparing Healthcare Costs of Patients Transitioning from Immediate-Release Oxycodone to Two Different Formulations of Extended-Release Oxycodone: Xtampza ER or OxyContin

Abstract

Purpose

Opioid therapy for managing chronic pain remains a challenge, as providers must weigh the medical benefit to the patient with the risk of adverse events. Manipulation of many extended-release (ER) opioid formulations may lead to increased serious medical outcomes or death. The economic burden of opioid use disorders due to opioid misuse and abuse may vary depending on which abuse deterrent opioid formulation is prescribed. The study aimed to compare demographic and clinical characteristics and healthcare costs of chronic pain patients treated with two different abuse-deterrent opioid formulations, Xtampza ER and reformulated OxyContin.

Methods

The source of data was IBM^® MarketScan^® Commercial Claims and Encounters Medicare Supplemental database, from January 2016 through February 2020. Patients with chronic pain were assigned to either the Xtampza ER or the OxyContin cohort based on the initial ER opioid prescription set as the index date. Continuous healthcare coverage was required during a minimum 3-month pre-index and 9-month post-index periods. Pre-index patients’ characteristics were analyzed. Healthcare costs of Xtampza ER vs OxyContin were assessed in the post-index period.

Results

After applying selection criteria, 464 patients were observed in the Xtampza ER cohort versus 1927 patients in the OxyContin cohort. In unmatched patients, ER opioid costs were lower for Xtampza ER than OxyContin ($2645 vs $3141; p<0.001), which ultimately led to lower total prescription costs for the Xtampza ER cohort compared to the OxyContin cohort ($7492 vs $8754; p=0.016). In matched patients, the total healthcare costs were significantly lower in the Xtampza ER cohort than in the OxyContin cohort, $22,630 vs $28,386 (p=0.005), respectively.

Conclusion

This study suggests that Xtampza ER may result in lower healthcare costs than OxyContin for a population of chronic pain patients switching from immediate release oxycodone based on real-world data.

Keywords:

• chronic pain
• opioids
• abuse-deterrent
• short-acting
• long-acting
• cost

Abbreviations

ADF, abuse-deterrent formulation; ASI-MV, addiction severity index-multimedia version; CCI, Charlson comorbidity score; CDHP, consumer-driven health plan; ED, emergency department; ER, extended release; EPO, exclusive provider organization; FDA, Food and Drug Administration; HDHP, high deductible health plan; HMO, health maintenance organization; IR, immediate release; NAVIPPRO, national addictions vigilance intervention and prevention program; NDC, national drug codes; NMU, non-medical use; Non-CapPOS, non-capitated point-of-service; OUD, opioid use disorders; PPO, preferred provider organization; PS, propensity score; RADARS^®, researched abuse, diversion and addiction-related surveillance system.

Data Sharing Statement

The data used in the analysis were extracted from the IBM MarketScan^® Commercial and Medicare Supplemental Databases. The MarketScan^® Research Databases are under the license of the IBM and are available from Vladimir Zah ([email protected]) upon reasonable request and with permission of the IBM and Endo Pharmaceutical Inc.

Ethics Approval and Informed Consent

Researchers confirmed they have obtained permission from the dataset owner to use the information in databases/repositories for the purposes of this research. The study was exempted from requiring ethical approval as all the data were de-identified and compliant with the US Health Insurance Portability and Accountability Act (HIPAA).

All patient data used in the current study were deidentified in compliance with the HIPAA. As such, there was no requirement for institutional review board approval and this aligns with ZRx Outcomes Research Inc., internal policies to waive the need for IRB review for these type of studies.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

OO, VZ, FS, DV, and PY are employees of ZRx Outcomes Research. VZ reports grants and/or personal fees from Glympse Bio, HutchMed Pharmaceuticals, Endo Pharmaceuticals, Stealth Biotherapeutics, RedHill Pharmaceuticals, and Collegium Pharmaceuticals, outside the submitted work. FS reports grants from Collegium Pharmaceutical Inc., during the conduct of the study. DV reports grants from Collegium Pharmaceutical, Inc., during the conduct of the study. CT, MKDG, and SP are employees of Collegium Pharmaceutical, Inc. The authors’ competing interests had no influence on study design, interpretation of the results or impose a censoring of the obtained results. The authors declare no other competing interest.

Additional information

Funding

This research was supported by Collegium Pharmaceutical, Inc. The source of funding had no influence on the study design, analysis, or interpretation of data.