Publication in Arthritis Care & Research

Cost-effectiveness of tramadol and oxycodone in the treatment of knee osteoarthritis

This evaluation of the cost-effectiveness of two frequently used opioids was published in Arthritis Care & Research in February 2017.

Why Opioid Cost-Effectiveness Matters

The United States spends over 1.5 billion dollars on prescription opioids for knee OA patients, and the cost of illicit use of opioids has been estimated at over 28 billion dollars.  It is essential to understand if opioids are providing enough benefit to warrant these costs.

Study Design

We used the OAPol model to evaluate the cost effectiveness of tramadol and oxycodone in persons with no major comorbidities. We tested three treatment options: 1) no opioids; 2) tramadol; 3) tramadol followed by oxycodone.

Our Results

Neither tramadol nor tramadol plus oxycodone were cost-effective for knee OA in our base case, primarily because opioids worsen outcomes for total knee replacement. If patients are unwilling or unable to undergo total knee replacement, opioids may be cost-effective.