Cost-effectiveness analysis of second-line pharmacological treatment of acromegaly in Spain
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Cost-effectiveness analysis of second-line pharmacological treatment of acromegaly in SpainAuthor(s)
Date
2020-05-06Citation
Peral C, Cordido F, Gimeno-Ballester V, Mir N, Sánchez-Cenizo L, Rubio-Rodríguez D, Rubio-Terrés C. Cost-effectiveness analysis of second-line pharmacological treatment of acromegaly in Spain. Expert Rev Pharmacoecon Outcomes Res. 2020 Feb;20(1):105-114.
Abstract
[Abstract]
Objective: To estimate the cost-effectiveness of second-line pharmacological treatments in patients
with acromegaly resistant to first-generation somatostatin analogues (FG SSA) from the Spanish
National Health System (NHS) perspective.
Methods: A Markov model was developed to analyze the cost-effectiveness of pegvisomant and
pasireotide in FG SSA-resistant acromegaly, simulating a cohort of patients from the treatment beginning to death. Treatment with pegvisomant or pasireotide was compared to FG SSA retreatment.
Efficacy data were obtained from clinical trials and utilities from the literature. Direct health costs
were obtained from Spanish sources (€2018).
Results: The Incremental Cost Effectiveness Ratio (ICER) of pegvisomant vs. FG SSA was €85,869/
Quality-adjusted life years (QALY). The ICER of pasireotide vs. FG SSA was €551,405/QALY. The ICER
was mainly driven by the incremental efficacy (4.41 QALY for pegvisomant vs. FG SSA and 0.71 QALY for
pasireotide vs. FG SSA), with a slightly lower increase in costs with pegvisomant (€378,597 vs. FG SSA)
than with pasireotide (€393,151 vs. FG SSA).
Conclusion: The ICER of pasireotide compared to FG SSA was six times higher than the ICER of
pegvisomant vs. FG SSA. Pegvisomant is a more cost-effective alternative for the treatment of acromegaly in FG SSA-resistant patients in the Spanish NHS.
Keywords
Acromegaly
Cost-effectiveness
Pasireotide
Pegvisomant
Somatostatin analogues
Cost-effectiveness
Pasireotide
Pegvisomant
Somatostatin analogues
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Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC-BY-NC-ND 4.0)
ISSN
1744-8379