Poster Number-79 - udget Impact Analysis of Xtampza® ER (oxycodone extended-release) for the Treatment of Chronic Pain from a Managed Care Perspective

Budget Impact Analysis of Xtampza^® ER (oxymorphone extended-release) for the Treatment of Chronic Pain from a Managed Care Perspective

Purpose:

Xtampza^® ER (oxycodone) is indicated for the management of pain severe enough to require daily, around-the-clock, long-term opioid treatment and for which alternative treatment options are inadequate. The development of abuse-deterrent opioids (ADO) of prescription opioids (RxO) is an important step toward deterring inappropriate use of these medications. Xtampza^® ER is an extended-release (ER) oxycodone tablet formulated with physiochemical properties to deter misuse/abuse via oral, intranasal (IN), and intravenous (IV) routes of administration. Previous studies have demonstrated that Xtampza^® ER has reduced drug liking (take drug again) relative to oxycodone IR for oral and IN administration. However, abuse of Xtampza^® ER by oral, IN and IV administration is still possible.
The objective of the model is to  estimate the potential financial impact to a hypothetical health plan of 1 million members 2 years after adding Xtampza^® ER to the health plan drug formulary or changing its formulary status.

Methods:

The model estimates incremental healthcare resource use (HCRU) and costs associated with RxO misuse/abuse based on a health plan’s RxO formulary coverage and utilization. RxO misuse/abuse rates, incremental HCRU and costs were informed by the 2020 National Survey on Drug Use and Health, an analysis of claims from Optum Health Care Solutions, Inc. and published literature. Proportions of RxO abuse cases attributable to oxycodone ER by route of administration were obtained from ASI-MV data.  In the base case analysis, RxO formulary shares were based on 2021-2022 IQVIA prescription data. After being added to the health plan’s formulary, Xtampza^® ER was assumed to account for 50% market share of oxycodone ER in year 1 (taking 50% from branded and 50% from generic oxycodone ER) and an additional 10% from branded and generic oxycodone ER in year 2 after formulary adoption. Wholesale acquisition costs without discounts/rebates were used for RxO prices. The p</span>roportion of misuse/abuse cases deterred by Xtampza^® ER due to its abuse-deterrent properties was assumed to be 80% for oral, IN, and IV routes of administration.    Sensitivity analyses were performed to evaluate changes in model outcomes, based on changes in various model inputs.

Results:

In the base case analysis, adding Xtampza^® ER to the drug formulary decreased abuse-related healthcare costs for a health plan of 1 million members by -$18,108,481 over two years (−$0.75452 per-member-per month [PMPM]).  In one-way sensitivity analyses on Xtampza^® ER’s abuse-deterrent properties, lowering IN abuse reduction to 30% resulted in cost savings of - $0.65985 PMPM. When IN abuse reduction was lowered to 20%, the total budget continued to show cost savings (-$0.63992PMPM).

Conclusion:

The budget impact model provides a framework to estimate the financial impact of including Xtampza^® ER on a drug formulary.  Placing Xtampza^® ER on a health plan’s drug formulary has the potential to result in cost differences to health plans and those who pay their premiums, depending on Xtampza^® ER’s market share and its effectiveness in deterring opioid misuse/abuse.

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