Administration of tyrosyl-D-arginyl-phenylalanyl-glycine amide to manage postoperative pain in patients with type 2 diabetes mellitus and obesity: budget impact analysis

Objective: To evaluate the impact of administering tyrosyl-D-arginyl-phenylalanyl-glycine amide postoperatively to relieve pain in patients with type 2 diabetes mellitus (T2DM) and obesity on the compulsory health insurance system of Moscow Region.
Material and methods. A pharmacoeconomic budget impact analysis covering a period of one year was conducted. The target population included T2DM and obesity patients aged over 18 years who received postoperative analgesic therapy (tyrosyl-D-arginyl-phenylalanylglycine amide, trimeperidine, or morphine). The regional budget impact analysis of drug therapy took into account the duration of analgesia, the incidence of complications and their treatment. A mathematical model was developed to calculate the direct medical costs of various postoperative analgesic regimens. The cost of pharmacotherapy and treatment of complications per patient during a course of medication was calculated. A sensitivity analysis of the obtained results was conducted.
Results. A total of 1501 patients with T2DM and obesity underwent surgical treatment at the medical facilities of Moscow Region. The total sample of patients in the study was divided into three groups depending on the analgesic used. With the use of tyrosyl-D-arginylphenylalanyl-glycine amide, the incidence of complications in the analyzed patient population was almost four times lower compared to trimeperidine and morphine, and the cost of treating complications was almost three times lower. The total cost of treating one surgical patient experiencing a complication after the use of tyrosyl-D-arginyl-phenylalanyl-glycine amide amounted to 18,732.25 rubles, which is almost 1.3 times lower compared to other analgesic strategies. The budget impact analysis revealed the pharmacoeconomic feasibility of using tyrosyl-D-arginyl-phenylalanyl-glycine amide in postoperative analgesic therapy. Sensitivity analysis showed that the results were robust to changes in the initial parameters.
Conclusion. Administration of tyrosyl-D-arginyl-phenylalanyl-glycine amide in the postoperative period leads to a proven reduction in the incidence of complications. This is a cost-effective approach to providing medical care to adult patients with T2DM and obesity.

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