Economic evaluation of OROS® hydromorphone for chronic pain: A Pan-European perspective


  • A. Brett Hauber, PhD
  • Jochen Fleischmann, PhD
  • Mickael Lothgren, PhD
  • Michele Wilson, MSPH
  • Annette Lam, MHEcon
  • Dominique Dubois, MD
  • Rainer Sabatowski, MD



OROS hydromorphone, chronic pain, economics


Objectives: OROS® hydromorphone (osmotic extended-release oral delivery system [OROS] hydromorphone) is a long-acting opioid analgesic, which is approved in Europe for the management of severe pain. The authors aimed to estimate the economic value of this product relative to other widely used oral opioids, including sustained-release morphine, extended-release (ER) oxycodone, and twice-daily (bid) hydromorphone.
Design: An adaptable, decision-analytic cost-utility model was developed. Separate versions of the model were developed for five European countries: Germany, Denmark, Slovakia, Portugal, and Italy.
Results: OROS hydromorphone represents a cost-effective alternative to other strong oral opioids in the treatment of both nonmalignant and malignant pain in all five countries. In the treatment of chronic severe nonmalignant pain, OROS hydromorphone was dominant (ie, lower cost and incremental quality-adjusted life years gains) when compared with ER oxycodone in Denmark and bid hydromorphone in Germany. Likewise, OROS hydromorphone was dominant in the treatment of chronic severe malignant pain when compared with ER oxycodone in both Germany and Denmark and when compared with bid hydromorphone in all markets where hydromorphone was marketed.
Conclusions: This model demonstrates the cost effectiveness of OROS hydromorphone relative to other strong oral opioids in the treatment of chronic severe malignant and nonmalignant pain.

Author Biographies

A. Brett Hauber, PhD

Senior Economist, RTI Health Solutions, Research Triangle Park, North Carolina.

Jochen Fleischmann, PhD

Head Health Economics & Market Access, Janssen-Cilag Germany, Neuss, Germany.

Mickael Lothgren, PhD

Director, International Health Economics and Reimbursement, GmbH (Europe), Zug, Switzerland.

Michele Wilson, MSPH

Associate Director, Health Economics, RTI Health Solutions, Research Triangle Park, North Carolina.

Annette Lam, MHEcon

Director, Health Economics and Reimbursement (CNS and Oncology), Medical and Government Affairs, Janssen-Ortho Inc., Toronto, Ontario.

Dominique Dubois, MD

Lecturer, Université Libre de Bruxelles (ULB), Brussels, Belgium.

Rainer Sabatowski, MD

Professor, Comprehensive Pain Center, Technical University Dresden, Dresden, Germany.


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How to Cite

Hauber, PhD, A. B., J. Fleischmann, PhD, M. Lothgren, PhD, M. Wilson, MSPH, A. Lam, MHEcon, D. Dubois, MD, and R. Sabatowski, MD. “Economic Evaluation of OROS® Hydromorphone for Chronic Pain: A Pan-European Perspective”. Journal of Opioid Management, vol. 7, no. 4, Jan. 2018, pp. 287-96, doi:10.5055/jom.2011.0070.