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Comparison of resource utilization by patients treated with transdermal fentanyl and long-acting oral opioids for nonmalignant pain.
MedLine Citation:
PMID:  15102218     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To quantify resource utilization and costs incurred for patients who received transdermal fentanyl as their first long-acting analgesic for non-malignant pain, and to compare these with utilization and costs for similar patients dispensed other long-acting oral opioids. DESIGN: A retrospective matched cohort study using medical claims data from a large New England Insurer. PATIENTS: We identified 478 patients without cancer who received transdermal fentanyl during 1995-1998. We selected patients who had no previous long-acting opioid dispensings and were enrolled during the 180 days before and 30 days following the initial dispensing. We used propensity scores to identify a matched comparison group of 478 long-acting oral opioid users. RESULTS: Transdermal fentanyl and matched long-acting oral opioid users incurred identical median costs for outpatient medical services and prescriptions during 2 years of follow-up. A larger proportion of transdermal fentanyl patients were still taking their initial opioid analgesic at the end of the 2-year follow-up than were patients initially taking other long-acting opioids. Use of short-acting opioids tapered off more slowly among transdermal fentanyl patients than among long-acting opioid patients. In the first 6 months, the transdermal fentanyl patients had more hospital discharges than the long-acting oral opioid patients, but this difference appeared to reflect preexisting conditions. CONCLUSIONS: Users of fentanyl transdermal system and other long-acting opioids experienced essentially identical evolution of health services utilization and costs over a 2-year period. The choice of long-acting opioid analgesia does not appear to be a determinant of future medical costs.
Authors:
Jeanne E Loughlin; J Alexander Cole; Sheri L Dodd; Jeffrey R Schein; Julie C Thornhill; Alexander M Walker
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pain medicine (Malden, Mass.)     Volume:  3     ISSN:  1526-2375     ISO Abbreviation:  Pain Med     Publication Date:  2002 Mar 
Date Detail:
Created Date:  2004-04-22     Completed Date:  2005-01-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100894201     Medline TA:  Pain Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  47-55     Citation Subset:  -    
Affiliation:
Ingenix Epidemiology, Newton, Massachusetts 02466, USA. jloughlin@epidemiology.com
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