Cost-effectiveness of topical glycopyrronium tosylate for the treatment of primary axillary hyperhidrosis.
| Autor: | Bloudek LM; Curta, Inc., Seattle, WA, USA., Gillard KK; Dermira, Inc., a wholly-owned subsidiary of Eli Lilly and company, Menlo Park, CA, USA., Nguyen VB; Curta, Inc., Seattle, WA, USA., Klein SZ; Department of Dermatology, University of Utah, Salt Lake City, UT, USA. |
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| Jazyk: | angličtina |
| Zdroj: | Journal of medical economics [J Med Econ] 2021 Jan-Dec; Vol. 24 (1), pp. 29-37. |
| DOI: | 10.1080/13696998.2020.1855879 |
| Abstrakt: | Aims: Primary axillary hyperhidrosis (PAHH) is a condition characterized by excessive sweating that negatively impacts health-related quality of life, with significant psychological and social impacts. Glycopyrronium tosylate (GT) is a topical anticholinergic approved in the United States for treatment of PAHH in patients 9 years of age and older. Our objective was to assess the cost-effectiveness of GT as first-line topical therapy compared to topical aluminum chloride from a United States commercial perspective. Materials and Methods: A Markov model was developed consisting of four health states based on the Hyperhidrosis Disease Severity Scale (HDSS) over a time horizon of 5 years with discount rates of 3% for both costs and outcomes. Transitions between health states were driven by HDSS response, defined as an improvement of ≥2 points. Non-responders and those who discontinue could switch to later line treatments or no treatment. Health utility scores were based on HDSS scores, supported by published literature. Results: Over 5 years, GT yielded 0.12 greater QALYs and 0.93 greater LYs with response compared to treatment with prescription aluminum chloride at an incremental cost of $10,584. Relative to prescription aluminum chloride, GT resulted in an incremental cost-effectiveness ratio (ICER) of $87,238 per QALY gained, $11,349 per LY with response. The ICER fell below $100,000 for 66% of probabilistic sensitivity analysis simulations and below $150,000 for 82% of simulations. Limitations: This analysis represents a simplified scenario of a hypothetical PAHH patient. Due to sparse data, assumptions were required for treatment patterns, efficacy, and persistence. Conclusion: Based on the analysis of incremental cost per QALY gained, GT may be cost-effective relative to prescription aluminum chloride at commonly accepted willingness to pay thresholds. |
| Databáze: | MEDLINE |
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