Economic Evaluation of Intravenous Immunoglobulin plus Corticosteroids for the Treatment of Steroid-Resistant Chronic Inflammatory Demyelinating Polyradiculoneuropathy in Thailand

Autor: Supinya Dechanont, Rosarin Sruamsiri, Nilawan Upakdee, Nathorn Chaiyakunapruk, David Bin-Chia Wu, Chayanin Pratoomsoot, Charungthai Dejthevaporn, Piyameth Dilokthornsakul, Naruemon Bamrungsawad
Rok vydání: 2016
Předmět:
Adult
Male
medicine.medical_specialty
Databases
Factual

Cost-Benefit Analysis
Drug Resistance
Drug resistance
Drug Costs
Disability Evaluation
03 medical and health sciences
0302 clinical medicine
Pharmacotherapy
Adrenal Cortex Hormones
hemic and lymphatic diseases
Internal medicine
Humans
Medicine
Pharmacology (medical)
030212 general & internal medicine
Aged
biology
business.industry
Immunoglobulins
Intravenous

Polyradiculoneuropathy
General Medicine
Middle Aged
Thailand
medicine.disease
Steroid resistant
Markov Chains
Quality-adjusted life year
Surgery
Models
Economic

Polyradiculoneuropathy
Chronic Inflammatory Demyelinating

Economic evaluation
Disease Progression
biology.protein
Female
Steroids
Quality-Adjusted Life Years
Antibody
business
Immunosuppressive Agents
030217 neurology & neurosurgery
Healthcare system
Zdroj: Clinical Drug Investigation. 36:557-566
ISSN: 1179-1918
1173-2563
DOI: 10.1007/s40261-016-0401-3
Popis: Intravenous immunoglobulin (IVIG) has been recommended for steroid-resistant chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). The treatment, however, is very costly to healthcare system, and there remains no evidence of its economic justifiability. This study aimed to conduct an economic evaluation (EE) of IVIG plus corticosteroids in steroid-resistant CIDP in Thailand.A Markov model was constructed to estimate the lifetime costs and outcomes for IVIG plus corticosteroids in comparison with immunosuppressants plus corticosteroids in steroid-resistant CIDP patients from a societal perspective. Efficacy and utility data were obtained from clinical literature, meta-analyses, medical record reviews, and patient interviews. Cost data were obtained from list prices, an electronic hospital database, published source, and patient interviews. All costs [in 2015 US dollars (US$)] and outcomes were discounted at 3 % annually. One-way and probabilistic sensitivity analyses were conducted.In the base-case, the incremental costs and quality-adjusted life years (QALYs) of IVIG plus corticosteroids versus immunosuppressants plus corticosteroids were US$2112.02 and 1.263 QALYs, respectively, resulting in an incremental cost-effectiveness ratio (ICER) of US$1672.71 per QALY gained. Sensitivity analyses revealed that the utility value of disabled patients was the greatest influence on ICER. At a societal willingness-to-pay threshold in Thailand of US$4672 per QALY gained, IVIG plus corticosteroids had a 92.1 % probability of being cost effective.At a threshold of US$4672 per QALY gained, IVIG plus corticosteroids is considered a cost-effective treatment for steroid-resistant CIDP patients in Thailand.
Databáze: OpenAIRE