OBJECTIVES : To evaluate the cost-effectiveness of Oxycodone Hydrochloride Controlled-release Tablets and Morphine Sulfate Sustained-release Tablets for moderate to severe cancer pain titration from the perspective of pharmacoeconomic.

METHODS : RCTs meeting the inclusion criteria were searched through Medline, Cochrane Library, Pubmed, EMbase, CNKI,VIP and WanFang database from the data of their establishment to July 2018. The efficacy and safety data were extracted from the included literature. Meta-analysis was conducted by Revman5.1.4. A Decision tree model was built to simulate cancer pain titration process. The initial dose of Oxycodone Hydrochloride Controlled-release Tablets and Morphine Sulfate Sustained-release Tablets group were 20mg and 30mg respectively. Oral immediate-release morphine was administered to treat break-out pain. The cost-effectiveness ratio and incremental cost-effectiveness ratio were performed with TreeAge Pro 2011.

RESULTS : 18 studies (1585 patients)were included in this study. Meta-analysis showed that pain control rate of Oxycodone Hydrochloride Controlled-release Tablets and Morphine Sulfate Sustained-release Tablets were 86% and 82.98% respectively. The cost of Oxycodone Hydrochloride Controlled-release Tablets and Morphine Sulfate Sustained-release Tablets were $23.27 and $13.31. The cost-effectiveness ratio of Oxycodone Hydrochloride Prolonged-release Tablets and Morphine Sulfate Sustained-release Tablets were $27.06/efficacy and $16.04/efficacy. The incremental cost-effectiveness ratio was approximate $329.76/efficacy. At the willingness-to-pay threshold of $8836, Oxycodone Hydrochloride Controlled-release Tablets was cost-effective, while the corresponding probability of being cost-effective at the willingness-to-pay threshold of $300 was 31.6%. One-way sensitivity analysis confirmed stability of outcomes.

CONCLUSIONS : Oxycodone Hydrochloride Controlled-release Tablets could be a cost-effectiveness option compared with Morphine Sulfate Sustained-release Tablets in moderate to severe cancer pain titration according to the threshold defined by WHO. Oxycodone Hydrochloride Controlled-release Tablets should be an optimization choice for moderate to severe cancer pain titration in China.