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Oluwadara Olatoke,1 Vladimir Zah,1 Filip Stanicic,1 Djurdja Vukicevic,1 Platonas Yfantopoulos,1 Christy Thompson,2 Michael K DeGeorge,2 Steven Passik2 1HEOR Department, ZRx Outcomes Research, Mississauga, Ontario, Canada; 2Medical Department, Collegium Pharmaceutical Inc., Stoughton, MA, USACorrespondence: Oluwadara Olatoke, HEOR Department, ZRx Outcomes Research Inc., 3450 Cawthra Road, Mississauga, ON, L5A 2X7, Canada, +1 416 953 4427, Email dara@outcomesresearch.caPurpose: 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

Vladimir Zah,1 Jovana Pelivanovic,1 Simona Tatovic,1 Djurdja Vukicevic,1 Martina Imro,1 Jane Ruby,2 David Hurley2 1Health Economics and Outcomes Research Department, ZRx Outcomes Research Inc., Mississauga, ON, Canada; 2Medical Affairs, Endo Pharmaceuticals Inc., Malvern, PA, USACorrespondence: Vladimir ZahZRx Outcomes Research Inc, Mississauga, ON, CanadaTel +1 416-953-4427Email vzah@outcomesresearch.caObjective: Studies examining differences in US healthcare resource utilization (HCRU) and associated healthcare costs between collagenase clostridium histolyticum (CCH) and fasciectomy for Dupuytren contracture (DC) are limited. This study evaluated US HCRU and direct healthcare cost for the treatment of DC in privately insured patients using insurance claims.Methods: This retrospective observational cohort study analyzed data from large nationwide insurance claims databases; it included individuals diagnosed with DC between July 1, 2011, and June 30, 2017, who were adults at index date (date of first treatment: CCH or fasciectomy). Participants had continuous health plan coverage 24 months pre-index and 12 months post-index date. All-cause and DC-related HCRU and healthcare costs from the payers’ perspective were compared between propensity score–matched cohorts. Generalized linear models assessed factors associated with all-cause total healthcare costs.Results: Of 83,983 patients diagnosed with DC, 1932 adults receiving fasciectomy and 953 adults receiving CCH were included. The mean ± standard deviation total all-cause healthcare cost was significantly lower with CCH than with fasciectomy (US$11,897 ± US$14,633 versus US$15,528 ± US$22,254, respectively; P< 0.001). After propensity score matching, 702 and 999 patients remained in the CCH and fasciectomy cohorts, respectively. In this analysis, all-cause and DC-related total costs were significantly lower in the CCH cohort versus the fasciectomy cohort (all-cause: US$11,044 ± US$12,856 versus US$12,912 ± US$19,237, respectively, P=0.02; DC-specific: US$3417 ± US$3671 versus US$5800 ± US$4985, P< 0.001), mainly due to the lower frequency of outpatient visits. CCH treatment and the use of a consumer-driven healthcare plan were associated with lower healthcare costs.Conclusion: Based on matched cohort data, adjusted 1-year healthcare costs for CCH-treated individuals were significantly lower compared with costs for fasciectomy-treated individuals.Keywords: injection, surgery, insurance claims, retrospective database study

Vladimir Zah,1 Rowe B Brookfield,2 Martina Imro,1 Simona Tatovic,1 Jovana Pelivanovic,1 Djurdja Vukicevic1 1Health Economics and Outcomes Research Department, ZRx Outcomes Research Inc, Mississauga, Ontario, Canada; 2Field Medical Affairs, Depomed, Inc, Newark, CA, USACorrespondence: Vladimir ZahHealth Economics and Outcomes Research Department, ZRx Outcomes Research Inc., 3373 Cawthra Road, Mississauga, Ontario, CanadaTel/fax +14169534427Email vzah@outcomesresearch.caPurpose: Chronic pain treatment imposes a substantial economic burden on US society. Treatment costs may vary across subgroups of patients with different types of pain. The aim of our study was to compare healthcare costs (HC) and resource utilization in musculoskeletal (MP), neuropathic (NP), and cancer pain (CaP) patients treated with long-acting opioids (LAO), using real-world evidence.Patients and methods: We compared total HC and resource utilization in subgroups of chronic pain patients (MP, NP or CaP) treated with three LAO alternatives: morphine-sulfate extended-release (MsER), oxycodone ER (OxnER) and tapentadol ER (TapER). Retrospective claims data were analyzed in the IBM Truven Health MarketScan® Commercial Claims Database (October 2012 through March 2016). All patients were continuously health plan enrolled for at least 12 months before the index date (first LAO prescription date) and during the LAO-treatment period. The cohorts were propensity-score matched.Results: A total of 2824 TapER-treated patients were matched to 16,716 OxnER-treated patients, while 2827 TapER patients were matched to 16,817 MsER patients. The average monthly total HC were lower in the TapER than in the OxnER cohort ($2510 vs. $3720, p

Zah V, Pelivanovic J, Tatovic S, et al. Clinicoecon Outcomes Res. 2020;12:635–643. The authors have advised that the Disclosure statement on page 642 is incorrect. The first sentence “Vladimir Zah, Djurdja Vukicevic, and Martina Imro are employees of ZRx Outcomes Research Inc. (institution founded by Endo Pharmaceuticals to conduct the present analysis), and have received grants from Endo Pharmaceuticals Inc” should read “Vladimir Zah, Djurdja Vukicevic, and Martina Imro are employees of ZRx Outcomes Research Inc. (institution funded by Endo Pharmaceuticals to conduct the present analysis), and have received grants from Endo Pharmaceuticals Inc”. The authors apologize for this error. Read the original article

Vladimir Zah,1,2 Mondher Toumi1 1Ecole Doctoral Interdisciplinaire Sciences-Santé (EDISS), University of Lyon, Lyon, France; 2ZRx Outcomes Research Inc., Mississauga, Canada Purpose: To model the budget and survival impact of implementing interventions to increase the proportion of HIV infections detected early in a given UK population. Patients and methods: A Microsoft Excel decision model was designed to generate a set of outcomes for a defined population. Survival was modeled on the Collaboration of Observational HIV Epidemiological Research Europe (COHERE) study extrapolated to a 5-year horizon as a constant hazard. Hazard rates were specific to age, sex, and whether detection was early or late. The primary outcomes for each year up to 5 years were: annual costs, numbers of infected cases, hospital admissions, and surviving cases. Three locations in the UK were chosen to model outcomes across a range of HIV prevalence areas: Lambeth, Southwark, and Lewisham (LSL), Greater Manchester Cluster (GMC), and Kent and Medway (K&M). Results: In LSL, the projected cumulative cost savings over 5 years were £3,210,206 or £5,290,206 when including the value of the 104 life-years saved. Savings were insensitive to transmission rates, but sensitive in direct proportion to the percentage shift from late to early detection. In GMC, savings were in a similar proportion to LSL, but the magnitude was smaller, as a consequence of the lower base-case HIV prevalence. In K&M, with a smaller population and lower HIV prevalence than GMC, savings were commensurately smaller (£733,202 cumulatively over 5 years). Conclusion: The results strengthen the rationale for implementing increased testing in high prevalence areas. However, in areas of low prevalence, it is unlikely that costs will be returned over a 5-year period. Keywords: HIV, testing, costs, savings, model