Cost-Effectiveness Analysis and Budget Impact: Antimuscarinics and Mirabegron for the Treatment of Patients With Urge Urinary Incontinence: The Brazilian Public Health System Perspective.

Autor: Zanghelini F; Department of Management and Incorporation of Health Technologies and Innovation, Ministry of Health, Brasília, Brazil. Electronic address: fernandozanghelini@gmail.com., Alves de Oliveira H Jr; Health Technology Assessment Unit, Hospital Alemão Oswaldo Cruz, São Paulo, Brazil., Castano Silva TB; Postgraduate Program in Medicines and Pharmaceutical Assistance, School of Pharmacy, Federal University of Minas Gerais, Minas Gerais, Brazil., da Silva Pereira D; Postgraduate Program in Collective Health, University of Brasília, Brasília, Brazil., Araújo de Oliveira GL; Department of Management and Incorporation of Health Technologies and Innovation, Ministry of Health, Brasília, Brazil.
Jazyk: angličtina
Zdroj: Value in health regional issues [Value Health Reg Issues] 2020 Dec; Vol. 23, pp. 85-92. Date of Electronic Publication: 2020 Sep 29.
DOI: 10.1016/j.vhri.2020.03.001
Abstrakt: Objectives: The Brazilian public health system does not cover pharmacotherapy for urge urinary incontinence (UUI). The aim of this study was to estimate the cost-effectiveness and budget impact of providing tolterodine, solifenacin, oxybutynin (OXY), darifenacin, and mirabegron for the treatment of UUI in Brazilian public health system.
Methods: A cost-effectiveness analysis with budget impact was performed. Six scenarios were assessed: in one scenario, all 5 therapeutic alternatives approved for coverage, and in the remaining 5 scenarios, only 1 alternative is approved for adoption for all patients. Clinical data were derived from a rapid systematic review conducted in several databases. One-way sensitivity analysis was also performed. The time horizon was 12 months.
Results: The cost-effectiveness analysis showed that patients treated with OXY had the lowest incremental cost-effectiveness ratio (ICER) per outcomes assessed (change in urinary incontinence episodes (UIE): R$1180.08; change in urge incontinence episodes: R$757.85 and change in micturition frequency: R$907.75), corresponding to a budget impact of R$17.9 billion over 5 years. The change in effectiveness measures was the parameter that most influenced the results of the ICER per patient-year.
Conclusion: The results of the study have shown that OXY and solifenacin had the lowest ICER per patient-year and the lowest budget impact when compared with other drugs.
(Copyright © 2020 ISPOR--The professional society for health economics and outcomes research. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: