Related Experiment Video
Updated: Apr 12, 2026

Acupoint Application Combined with Acupoint Massage for Treating Constipation in a Patient with Chronic Obstructive Pulmonary Disease
Published on: August 18, 2023
Cost-Effectiveness of Prophylactic Naldemedine for Opioid-Induced Constipation in Patients with Cancer
Reiko Okubo1,2, Takahiro Higashibata3, Masahide Kondo1
1Department of Health Care Policy and Health Economics, Institute of Medicine, University of Tsukuba, Tsukuba, Japan.
Background:
Clinical guidelines recommend naldemedine for opioid-induced constipation in patients with cancer, either with conventional laxatives or as a first-choice option. Making prophylactic naldemedine a new standard treatment for opioid-induced constipation requires a demonstration of its value for money.
Objectives:
We aimed to evaluate the cost-effectiveness of prophylactic naldemedine in patients with cancer initiating strong opioid therapy.
Design:
We conducted a cost-effectiveness analysis of prophylactic naldemedine replacing standard, nonprophylactic use from the payer's perspective, using a decision tree model based on data from a multicenter, double-blind, randomized controlled trial in Japan.
Setting/Subjects:
The study population included patients aged ≥20 years and initiating strong opioid therapy for the first time.
Results:
The incremental cost-effectiveness ratio of prophylactic naldemedine for opioid-induced constipation was 1,445,276 Japanese yen (¥) or 9,635 United States dollars (USD) with an exchange rate of 1 USD = 150 ¥ per quality-adjusted life year. Using the official value of social willingness-to-pay threshold in Japan of 5 million ¥ or 33,333 USD per quality-adjusted life year gained, prophylactic naldemedine was found to be cost-effective.
Conclusions:
This is the first global cost-effectiveness analysis of prophylactic naldemedine in patients with cancer. Prophylactic naldemedine for opioid-induced constipation in patients with cancer initiating strong opioid therapy could be justifiable as an efficient use of finite health care resources.
More Related Videos
Related Concept Videos
Drugs for Treatment of Constipation-Predominant IBS
Drugs Affecting GI Tract Motility: Opioids as Antidiarrheal Agents
Opioids, widely used antidiarrheal agents, mitigate diarrhea by slowing down...
Drugs for Treatment of Diarrhea-Predominant IBS
Two specific drugs used in the treatment are alosetron (Lotronex) and eluxadoline (Viberzi). Alosetron, a 5-HT3 antagonist, works by slowing the movement of stools in the gut, reducing bowel...
Chemotherapy-Induced Nausea and Vomiting: 5-HT3 Receptor Antagonists
Chemotherapy-Induced Nausea and Vomiting: Dopamine Receptor Antagonists
Phenothiazines, such as prochlorperazine...
Chemotherapy-Induced Nausea and Vomiting: Cannabinoids
Two synthetic agonists of THC,...

