Asunto(s)
Modafinilo/uso terapéutico , Narcolepsia/terapia , Guías de Práctica Clínica como Asunto , Promotores de la Vigilia/uso terapéutico , Australia/epidemiología , Dextroanfetamina/economía , Dextroanfetamina/uso terapéutico , Costos de los Medicamentos/normas , Gastos en Salud/normas , Accesibilidad a los Servicios de Salud/economía , Accesibilidad a los Servicios de Salud/normas , Humanos , Metilfenidato/economía , Metilfenidato/uso terapéutico , Modafinilo/economía , Narcolepsia/diagnóstico , Narcolepsia/economía , Narcolepsia/epidemiología , Polisomnografía , Prevalencia , Ensayos Clínicos Controlados Aleatorios como Asunto , Oxibato de Sodio/economía , Oxibato de Sodio/uso terapéutico , Resultado del Tratamiento , Promotores de la Vigilia/economíaRESUMEN
AIMS AND OBJECTIVES: Based on class-I studies, sodium oxybate is regarded as a first-line treatment for both EDS and cataplexy. The cost-effectiveness of sodium oxybate is largely unknown, though. In this study, we estimate the cost-effectiveness of sodium oxybate as treatment for patients with narcolepsy as compared to standard treatment, by calculating incremental cost-effectiveness ratios (cost per quality-adjusted life year, QALY) for patients in a Swedish setting. MATERIALS AND METHODS: Calculations were performed using a Markov model with a 10-year time horizon. The study population consisted of adult patients treated for narcolepsy with cataplexy. Healthcare utilization and quality-adjusted life years (QALYs) for each treatment alternative were calculated assuming no treatment effect on survival. Sensitivity analyses were performed for treatment effectiveness and healthcare cost parameters. RESULTS: The cost per additional quality-adjusted life year was estimated at SEK 563,481. The cost-effectiveness measure was demonstrated to be particularly sensitive to the duration of the relative quality-of-life improvements accruing to patients treated with sodium oxybate. CONCLUSIONS: The estimated cost per additional QALY for the sodium oxybate treatment alternative compared with standard treatment was estimated above the informal Swedish willingness-to-pay threshold (SEK 500,000). The estimated cost per additional QALY obtained here is likely to overestimate the true cost-effectiveness ratio as potentially beneficial effects on productivity of treatment with sodium oxybate were not included (due to lack of data).