OBJECTIVES : This research estimates the population pharmacoeconomic benefits of over-the-counter (OTC) topical diclofenac in the treatment of mild-to-moderate acute pain or injury in Sweden. Topical diclofenac is an effective analgesic treatment, and OTC status allows first-line access without consuming constrained healthcare resources.

METHODS : The analysis compares use of topical diclofenac OTC as a first-line treatment option with a mixture of alternative OTC treatments (Topical Ibuprofen, Systemic Paracetamol, or other Systemic OTC). The proportions of patients using alternative OTC treatments were based on market share data and medical opinion. The treatment success rates were sourced from Cochrane reviews. The analysis reports first and second-line pharmacy costs, second-line physician visit costs, work productivity hours lost, and days not at full health. Reduced health state utilities are assigned for days with acute pain and are used to calculate quality-adjusted life years (QALYs).

RESULTS : There were 1,096,219 uses of topical diclofenac OTC for acute pain in Sweden in 2018. If topical diclofenac OTC were not used, an estimated 548,110, 234,591, and 313,519 patients would use Topical Ibuprofen, Systemic Paracetamol, or other Systemic OTC, respectively. In the topical diclofenac OTC vs. alternative OTC mixture first-line treatment comparison, overall cost savings of SEK 543,293,216 were realized, with savings for both patient and government payers. topical diclofenac OTC also showed improved quality of life with 2,181.8 incremental QALYs compared to the alternative OTC mixture. topical diclofenac OTC was associated with 995,348 fewer work productivity hours lost, 2,903,097 fewer days not at full health, and 414,728 fewer physician visits.

CONCLUSIONS : Use of topical diclofenac OTC vs. alternate OTC treatment mixtures as a first-line treatment for mild-to-moderate acute pain or injury in Sweden results in cost savings, work productivity benefits, and reduced use of healthcare resources.