Cost-Effectiveness Analysis of Lesinurad/Allopurinol Versus Febuxostat for the Management of Gout/Hyperuricemia in Italy.
Pharmacoeconomics
; 36(5): 625-636, 2018 05.
Article
em En
| MEDLINE
| ID: mdl-29557073
ABSTRACT
BACKGROUND:
Until very recently the only therapeutic alternative for the management of patients affected by gout/hyperuricemia that did not respond to a first-line treatment based on allopurinol alone or who cannot tolerate allopurinol was febuxostat, a xanthine oxidase non-purine-selective inhibitor. Lately, however, a new therapeutic alternative has become available for the management of this pathology lesinurad, a urate transporter inhibitor.OBJECTIVE:
To objective of this study was to evaluate the cost effectiveness of lesinurad/allopurinol in comparison with febuxostat as a second-line therapeutic strategy for the management of patients affected by gout and hyperuricemia that did not respond to a first-line therapy based on allopurinol alone.METHODS:
A Markov model was built based on the natural history of the pathology; patients entered the model according to their level of serum uric acid concentration and flowed across it according to their response to the therapy. The analysis was carried out considering the perspective of the Italian National Health Service on a lifetime horizon and 6-month cycles. Costs and quality-adjusted life-years (QALYs) were discounted at a 3.5% yearly rate. The results of the model were expressed in terms of incremental cost-effectiveness ratio (ICER). Both a one-way and a multi-way Monte-Carlo analysis were carried out in order to check the robustness of the results achieved.RESULTS:
The ICER derived from the comparison was equal to 77.53/QALY on the lifetime horizon, as there was a higher level of costs associated with the combination as compared with febuxostat (10,658.27 vs. 10,645.87, for a differential of 12.40) and a higher level of QALYs achieved (7.77 vs. 7.61, for a differential of 0.16).CONCLUSIONS:
The lesinurad/allopurinol combination is recommended for the treatment of patients affected by gout/hyperuricemia in the Italian Health System as it appears to be cost effective and thus sustainable for the Italian healthcare sector.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Tioglicolatos
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Triazóis
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Alopurinol
/
Análise Custo-Benefício
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Hiperuricemia
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Febuxostat
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Gota
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article