ECONOMIC EVALUATION OF A FIXED-DOSE INTRANASAL KETAMINE AND SUFENTANIL COMBINATION FOR PEDIATRIC ACUTE PAIN IN SWEDEN
Author(s)
Nikos Kotsopoulos, MSc, PhD1, Mark Connolly, BA, MSc, PhD2, Mamuka Teneishvili, MD3.
1Global Market Access Solutions, Chardonne, Switzerland, 2Researcher, Global Market Access Solutions LLC, Mooresville, NC, USA, 3Proveca Pharma, Manchester, United Kingdom.
1Global Market Access Solutions, Chardonne, Switzerland, 2Researcher, Global Market Access Solutions LLC, Mooresville, NC, USA, 3Proveca Pharma, Manchester, United Kingdom.
OBJECTIVES: Managing acute moderate-to-severe pain in children is a significant clinical challenge, as traditional intravenous (IV) administration can be traumatic and time-consuming, while oral options often have a slow onset. Intranasal (IN) delivery offers a needle-free, rapid alternative that bypasses first-pass metabolism. We evaluated whether the synergistic effects of a fixed-dose combination of IN sufentanil/ketamine (S/K), against current treatment standards for acute pediatric pain (ages 1-17) could save time and hospital resources.
METHODS: A cost-minimization analysis (CMA) was performed from the Swedish public healthcare perspective, assuming equal efficacy across interventions in three settings: Emergency room, ambulance and procedural setting to reflect the full spectrum of peri-hospital and hospital acute pain events. The model utilized a decision tree structure to compare S/K against IV morphine, IV fentanyl, IN fentanyl, general anesthesia, and regional nerve blocks. Cost inputs included drug acquisition (Pharmacy Purchase Price), healthcare resource utilization (staff time and consumables), adverse event (AE) management, and excess hospitalization due to respiratory depression obtained from published literature.
RESULTS: We observe S/K was cost-saving compared to all assessed treatments. The total cost for IN S/K was 602.72 SEK, resulting in incremental savings per patient of 1,510.01 SEK versus IV morphine, 993.23 SEK versus IV fentanyl, and 577.32 SEK versus IN fentanyl. Although IN S/K had higher acquisition costs (332.10 SEK) for the 90 mcg/90 mg dosing pack, these were offset by substantially lower administration costs (88.23 SEK) and reduced AE-related costs (38.87 SEK). Probabilistic sensitivity analysis confirmed a 98% likelihood of cost-savings against the closest comparator, IN fentanyl.
CONCLUSIONS: The intranasal sufentanil/ketamine combination represents a cost-saving alternative for managing pediatric acute pain in Sweden. Its economic value is primarily driven by reduced staff requirements for administration and a lower clinical and financial burden from adverse events.
METHODS: A cost-minimization analysis (CMA) was performed from the Swedish public healthcare perspective, assuming equal efficacy across interventions in three settings: Emergency room, ambulance and procedural setting to reflect the full spectrum of peri-hospital and hospital acute pain events. The model utilized a decision tree structure to compare S/K against IV morphine, IV fentanyl, IN fentanyl, general anesthesia, and regional nerve blocks. Cost inputs included drug acquisition (Pharmacy Purchase Price), healthcare resource utilization (staff time and consumables), adverse event (AE) management, and excess hospitalization due to respiratory depression obtained from published literature.
RESULTS: We observe S/K was cost-saving compared to all assessed treatments. The total cost for IN S/K was 602.72 SEK, resulting in incremental savings per patient of 1,510.01 SEK versus IV morphine, 993.23 SEK versus IV fentanyl, and 577.32 SEK versus IN fentanyl. Although IN S/K had higher acquisition costs (332.10 SEK) for the 90 mcg/90 mg dosing pack, these were offset by substantially lower administration costs (88.23 SEK) and reduced AE-related costs (38.87 SEK). Probabilistic sensitivity analysis confirmed a 98% likelihood of cost-savings against the closest comparator, IN fentanyl.
CONCLUSIONS: The intranasal sufentanil/ketamine combination represents a cost-saving alternative for managing pediatric acute pain in Sweden. Its economic value is primarily driven by reduced staff requirements for administration and a lower clinical and financial burden from adverse events.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE555
Topic
Economic Evaluation, Health Service Delivery & Process of Care, Medical Technologies
Topic Subcategory
Budget Impact Analysis
Disease
Injury & Trauma, Pediatrics