OBJECTIVE: To conduct a cost-effectiveness analysis of riociguat and bosentan in the management of chronic thromboembolic pulmonary hypertension (CTEPH) from a United States payer perspective.
METHODS: A Markov model was developed following the recommendations of the International Society of Pharmacoeconomics and Outcomes Research - Society for Medical Decision Making Modeling Good Research Practices. A cohort of patients with inoperable CTEPH or post-pulmonary endarterectomy CTEPH were simulated over their lifetime. Health outcomes were measured as quality-adjusted life years (QALY). Efficacy and safety data were obtained from BENEFiT and CHEST-1 trials. Drugs costs, associated costs for the management of CTEPH, were obtained from Redbook and published information such as the Healthcare Cost and Utilization Project (HCUPnet) and Centers for Medicare & Medicaid Services Physician Fee Schedule. Deterministic and probabilistic sensitivity analyses were performed to assess the robustness of the model projections.
RESULTS: Riociguat was more effective than bosentan with an incremental cost of $132,065 and an incremental quality-adjusted life year (QALY) of 0.20, corresponding to an incremental cost-effectiveness ratio (ICER) of -$649,380 per QALY (in favor of riociguat). Riociguat had a lower total discounted lifetime cost compared to bosentan ($2,307,488 versus $2,439,555). Probabilistic sensitivity analyses confirmed dominance of riociguat in 74% of the Monte Carlo simulations.
CONCLUSIONS: Results of this model indicates that riociguat is more effective and less costly than bosentan in the management of patients with inoperable CTEPH or post-pulmonary endarterectomy CTEPH.
| Identifer | oai:union.ndltd.org:bu.edu/oai:open.bu.edu:2144/27101 |
| Date | 08 November 2017 |
| Creators | Ashaye, Ajibade O. |
| Source Sets | Boston University |
| Language | en_US |
| Detected Language | English |
| Type | Thesis/Dissertation |
| Rights | Attribution-NonCommercial-NoDerivatives 4.0 International, http://creativecommons.org/licenses/by-nc-nd/4.0/ |
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