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阿片类药物相关临床结局和滥用/误用羟考酮制剂后的相关医疗保健费用:来自真实世界数据的 HEOR 分析。

Opioid-related clinical outcomes and associated healthcare costs following abuse/misuse of oxycodone formulations: A HEOR analysis from real-world data.

机构信息

Uprise Health/Inflexxion, Irvine, California. ORCID: https://orcid.org/0000-0003-1776-6400.

Uprise Health/Inflexxion, Irvine, California. ORCID: https://orcid.org/0000-0002-2942-4267.

出版信息

J Opioid Manag. 2024 Jul-Aug;20(4):281-288. doi: 10.5055/jom.0878.

Abstract

OBJECTIVE

The United States (US) opioid epidemic is a continued burden on the healthcare system and on the lives of individuals affected by the consequences of opioid abuse/misuse. The objective of this study was to use real-world data from intentional abuse/misuse exposures managed by US poison centers to compare clinical outcomes and quantify healthcare costs among three study cohorts: -exposures that involved Xtampza ER®, other oxycodone extended-release (ER), and oxycodone immediate-release (IR).

STUDY DESIGN

A real-world, observational study.

MAIN OUTCOME MEASURES

Descriptive statistics were used to describe patient and exposure characteristics. Drug utilization-adjusted rates of intentional abuse/misuse and clinical outcomes were used to determine relative risk. Healthcare cost estimates were calculated by extrapolating average charge per opioid-related disorder emergency department (ED) visit and per inpatient stay based upon case disposition rates, adjusted for population and drug utilization.

RESULTS

Compared to Xtampza ER, exposures that involved other oxycodone ER were 7.4 times more likely to be intentional abuse/misuse, 25.9 times more likely to result in major effect or death, 9.7 times more likely to require a visit to the ED, and 14.3 times more likely to result in hospital admission. Similar results were found for oxycodone IR when compared to Xtampza ER.

CONCLUSIONS

This study is the first of its kind to synthesize clinical outcomes with opioid-related healthcare costs, suggesting that even when Xtampza ER is abused/misused, the rates of major effect/death, ED visits, and hospital admissions were significantly lower than those for other oxycodone-containing medications, resulting in relatively low downstream opioid-related healthcare costs.

摘要

目的

美国(美国)阿片类药物流行是对医疗保健系统的持续负担,也是受阿片类药物滥用/误用后果影响的个人的生活负担。本研究的目的是使用美国中毒中心管理的故意滥用/误用暴露的真实世界数据,比较三个研究队列的临床结果并量化医疗保健成本:-涉及 Xtampza ER ®、其他羟考酮缓释(ER)和羟考酮即时释放(IR)的暴露。

研究设计

真实世界、观察性研究。

主要观察指标

描述性统计数据用于描述患者和暴露特征。药物利用调整后的故意滥用/误用和临床结果发生率用于确定相对风险。根据病例处置率,根据人口和药物利用情况,从每个阿片类药物相关疾病急诊(ED)就诊和每个住院患者的平均费用外推计算医疗保健成本估计值。

结果

与 Xtampza ER 相比,涉及其他羟考酮 ER 的暴露更有可能是故意滥用/误用,发生严重影响或死亡的可能性高 25.9 倍,需要 ED 就诊的可能性高 9.7 倍,住院的可能性高 14.3 倍。与 Xtampza ER 相比,羟考酮 IR 也有类似的结果。

结论

这项研究是同类研究中首次将临床结果与阿片类药物相关的医疗保健成本相结合,表明即使 Xtampza ER 被滥用/误用,严重影响/死亡、ED 就诊和住院的发生率仍明显低于其他含羟考酮的药物,导致阿片类药物相关的医疗保健成本相对较低。

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