Kenworthy J, Langham S, Wright A, Dunlop W. Budget impact analysis of methoxyflurane (Penthrox®) for emergency relief of moderate-to-severe trauma pain in the Swedish setting. Value Health 2018;21(Suppl 3):S443

Abstract

Objectives: Trauma pain is highly prevalent in emergency settings and undertreatment is common, partly due to administrative requirements of current analgesics. This imposes a burden on patients and healthcare providers. Methoxyflurane (Penthrox®), a non-opioid inhaled analgesic, is indicated for emergency relief of moderate-to-severe trauma and associated pain in conscious adults and is patient administered and controlled. Clinical evidence has demonstrated a rapid onset and offset of action, making it particularly suitable for pain relief in musculoskeletal trauma patients (fractures, dislocations and sprains) and potentially those requiring a bridging analgesic. We performed a budget impact evaluation of potentially introducing methoxyflurane in Sweden and explored potential cost efficiencies compared to current analgesics.

Methods: A budget impact model was developed using local epidemiological and drug-cost data. The base case assumed a utilisation rate of methoxyflurane between 25% and 50% of eligible patients, with no displacement of current analgesics. National annual budget impact was estimated (for 2018 in SEK), broken down into eligible musculoskeletal patient groups. Scenario analyses explored assumptions around displacement of alternative analgesics (e.g. morphine intravenous injections) and associated costs (including administration).

Results: National annual budget impact of treating musculoskeletal trauma pain with methoxyflurane ranged from just over SEK0.5 million to just under SEK20 million depending on utilisation rate, type of trauma and emergency setting (prehospital or hospital). Scenario analyses demonstrated considerable efficiency savings through a reduction in administration costs associated with alternative analgesics, which could result in a total cost saving to the health system.

Conclusions: Budget impact estimates allow decision makers to make informed choices on use of methoxyflurane in relation to patient groups and settings. When used in a group of eligible patients with high benefit, methoxyflurane has the potential to diminish the burden associated with undertreatment and reduce the need for alternative analgesics.