Resumen de Effectiveness of immediate release fentanyls in the management of breakthrough cancer pain

Raquel Peláez Romero, José Luis Aguilar Sánchez, Patricia Hernández Puiggros, Juan Carlos Pérez Pons

• Objective: Breakthrough Cancer Pain (BTCP) is a prognostic factor of poor associated cost are increasingly present. The objective was to define the most pain control. The several formulations of fentanyl for BTCP treatment and the efficient formulation of fentanyl for BTCP management in our hospital and in its area of influence.

  Method: An analysis of the consumption and cost data (including hospital and walk-in clinics) and a review of the evidence on the efficacy and effectiveness of the fentanyls for BTCP were performed.

  Results: There are not clinical trials that compare fentanyl formulations.Which one is ideal remains to be defined. After analysing the total health cost, the average amount per dose, the cost per patient and the cost per patient per month of treatment, it was found that sublingual fentanyl and fentanyl pectin nasal spray are the most effective in primary healthcare and fentanyl aqueous nasal spray is the most cost effective in the hospital.

  Discussion: Uncontrolled BTCP increases direct and indirect costs given that not one of fentanyl has been proven to be more effective, other aspects are considered: the clinical experience, the environment or the preferences and abilities of the patient or his/her carers. We must also consider aspects that minimise healthcare costs.

  Conclusions: In our hospital the most economic drug per dose is fentanyl aqueous nasal spray in a single dose container. In the same period, in our area of primary healthcare, the most economic drug is sublingual fentanyl and fentanyl pectin nasal spray