The 5% Lidocaine-Medicated Plaster: Its Inclusion in International Treatment Guidelines for Treating Localized Neuropathic Pain, and Clinical Evidence Supporting its Use

<p><b>Article full text</b></p> <p><br></p> <p>The full text of this article can be found here<b>.</b> <a href="https://link.springer.com/article/10.1007/s40122-016-0060-3">https://link.springer.com/article/10.1007/s40122-016-0060-3</a></p><p></p> <p><br></p> <p><b>Provide enhanced content for this article</b></p> <p><br></p> <p>If you are an author of this publication and would like to provide additional enhanced content for your article then please contact <a href="http://www.medengine.com/Redeem/”mailto:[email protected]”"><b>[email protected]</b></a>.</p> <p><br></p> <p>The journal offers a range of additional features designed to increase visibility and readership. All features will be thoroughly peer reviewed to ensure the content is of the highest scientific standard and all features are marked as ‘peer reviewed’ to ensure readers are aware that the content has been reviewed to the same level as the articles they are being presented alongside. Moreover, all sponsorship and disclosure information is included to provide complete transparency and adherence to good publication practices. This ensures that however the content is reached the reader has a full understanding of its origin. No fees are charged for hosting additional open access content.</p> <p><br></p> <p>Other enhanced features include, but are not limited to:</p> <p><br></p> <p>• Slide decks</p> <p>• Videos and animations</p> <p>• Audio abstracts</p> <p>• Audio slides</p

Cost-effectiveness analysis of oral fentanyl formulations for breakthrough cancer pain treatment

<div><p>Breakthrough cancer Pain (BTcP) has a high prevalence in cancer population. Patients with BTcP reported relevant health care costs and poor quality of life. The study assessed the cost-effectiveness of the available Oral Fentanyl Formulations (OFFs) for BTcP in Italy. A decision-analytical model was developed to estimate costs and benefits associated with treatments, from the Italian NHS perspective. Expected reductions in pain intensity per BTcP episodes were translated into, percentage of BTcP reduction, resource use and Quality-Adjusted-Life-Years (QALYs). Relative efficacy, resources used and unit costs data were derived from the literature and validated by clinical experts. Probabilistic and deterministic sensitivity analyses were performed. At base-case analysis, Sublingual Fentanyl Citrate (FCSL) compared to other oral formulations reported a lower patient’s cost (€1,960.8) and a higher efficacy (18.7% of BTcP avoided and 0.0507 QALYs gained). The sensitivity analyses confirmed the main results in all tested scenarios, with the highest impact reported by BTcP duration and health care resources consumption parameters. Between OFFs, FCSL is the cost-effective option due to faster reduction of pain intensity. However, new research is needed to better understand the economic and epidemiologic impact of BTcP, and to collect more robust data on economic and quality of life impact of the different fentanyl formulations.</p><p>Different fentanyl formulations are available to manage BTcP in cancer population. The study is the first that assesses the different impact in terms of cost and effectiveness of OFFs, providing new information to better allocate the resources available to treat BTcP and highlighting the need of better data.</p></div

Model parameters: Costs.

<p>Model parameters: Costs.</p

Model parameters: Base case.

<p>Model parameters: Base case.</p

Base-case analysis results.

<p>Base-case analysis results.</p

PI curves during a BTcP, derived from trials data.

<p>FCSL = Sublingual Fentanyl Citrate; OTFC = Oral Transmucosal Fentanyl Citrate; FBT = Fentanyl Buccal Tablet; FBSF = Fentanyl Buccal Soluble Film; FST = Fentanyl Sublingual Tablets.</p

CEAC at base-case scenario.

<p>FCSL = Sublingual Fentanyl Citrate; FBSF = Fentanyl Buccal Soluble Film; FBT = Fentanyl Buccal Tablet; OTFC = Oral Transmucosal Fentanyl Citrate; FST = Fentanyl Sublingual Tablets.</p

Deterministic sensitivity analysis: Results of the 7 alternative scenarios tested.

<p>Deterministic sensitivity analysis: Results of the 7 alternative scenarios tested.</p

ROC analysis of normalised Act_A11 activity with PainOmics versus control serum samples.

<p>The Area Under the Curve (AUC) of 0.51 ± 0.06 indicates this marker is essentially invariant between serum controls versus PainOmics samples, thereby confirming the homogeneity of the various samples received.</p

Test of sample integrity.

<p> Normalised carboxypeptidase activity for PainOmics samples analysed (<i>A</i>) by centre and (<i>B</i>) as a whole PainOmics group versus control serum samples. (Control = 1.0 ± 0.1 versus PainOmics = 1.0 ± 0.2; unpaired t test <i>P</i> = 0.6). Each data point represents an individual patient sample (average of <i>n</i> = 8 replicates).</p