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 |
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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 |
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