IDEAS home Printed from https://ideas.repec.org/a/spr/pharme/v36y2018i5d10.1007_s40273-018-0643-4.html
   My bibliography  Save this article

Cost-Effectiveness Analysis of Lesinurad/Allopurinol Versus Febuxostat for the Management of Gout/Hyperuricemia in Italy

Author

Listed:
  • M. Ruggeri

    (Catholic University of Sacred Heart)

  • M. Basile

    (Catholic University of Sacred Heart)

  • C. Drago

    (“Niccolò Cusano” University)

  • F. R. Rolli

    (Catholic University of Sacred Heart)

  • A. Cicchetti

    (Catholic University of Sacred Heart)

Abstract

Background Until very recently the only therapeutic alternative for the management of patients affected by gout/hyperuricemia that did not respond to a first-line treatment based on allopurinol alone or who cannot tolerate allopurinol was febuxostat, a xanthine oxidase non-purine-selective inhibitor. Lately, however, a new therapeutic alternative has become available for the management of this pathology: lesinurad, a urate transporter inhibitor. Objective To objective of this study was to evaluate the cost effectiveness of lesinurad/allopurinol in comparison with febuxostat as a second-line therapeutic strategy for the management of patients affected by gout and hyperuricemia that did not respond to a first-line therapy based on allopurinol alone. Methods A Markov model was built based on the natural history of the pathology; patients entered the model according to their level of serum uric acid concentration and flowed across it according to their response to the therapy. The analysis was carried out considering the perspective of the Italian National Health Service on a lifetime horizon and 6-month cycles. Costs and quality-adjusted life-years (QALYs) were discounted at a 3.5% yearly rate. The results of the model were expressed in terms of incremental cost-effectiveness ratio (ICER). Both a one-way and a multi-way Monte–Carlo analysis were carried out in order to check the robustness of the results achieved. Results The ICER derived from the comparison was equal to €77.53/QALY on the lifetime horizon, as there was a higher level of costs associated with the combination as compared with febuxostat (€10,658.27 vs. €10,645.87, for a differential of €12.40) and a higher level of QALYs achieved (7.77 vs. 7.61, for a differential of 0.16). Conclusions The lesinurad/allopurinol combination is recommended for the treatment of patients affected by gout/hyperuricemia in the Italian Health System as it appears to be cost effective and thus sustainable for the Italian healthcare sector.

Suggested Citation

  • M. Ruggeri & M. Basile & C. Drago & F. R. Rolli & A. Cicchetti, 2018. "Cost-Effectiveness Analysis of Lesinurad/Allopurinol Versus Febuxostat for the Management of Gout/Hyperuricemia in Italy," PharmacoEconomics, Springer, vol. 36(5), pages 625-636, May.
    • Handle: RePEc:spr:pharme:v:36:y:2018:i:5:d:10.1007_s40273-018-0643-4
    DOI: 10.1007/s40273-018-0643-4
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1007/s40273-018-0643-4
    File Function: Abstract
    Download Restriction: Access to the full text of the articles in this series is restricted.
    File URL: https://libkey.io/10.1007/s40273-018-0643-4?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. M. Ruggeri & M. Basile & S. Coretti & C. Drago & A. Cicchetti, 2017. "Economic Analysis and Budget Impact of Tenofovir and Entecavir in the First-Line Treatment of Hepatitis B Virus in Italy," Applied Health Economics and Health Policy, Springer, vol. 15(4), pages 479-490, August.
    2. Briggs, Andrew & Sculpher, Mark & Claxton, Karl, 2006. "Decision Modelling for Health Economic Evaluation," OUP Catalogue, Oxford University Press, number 9780198526629.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Chiranjeev Sanyal & Don Husereau, 2020. "Systematic Review of Economic Evaluations of Services Provided by Community Pharmacists," Applied Health Economics and Health Policy, Springer, vol. 18(3), pages 375-392, June.
    2. Arantzazu Arrospide & Oliver Ibarrondo & Iván Castilla & Igor Larrañaga & Javier Mar, 2022. "Development and Validation of a Discrete Event Simulation Model to Evaluate the Cardiovascular Impact of Population Policies for Obesity," Medical Decision Making, , vol. 42(2), pages 241-254, February.
    3. Mark Oppe & Daniela Ortín-Sulbarán & Carlos Vila Silván & Anabel Estévez-Carrillo & Juan M. Ramos-Goñi, 2021. "Cost-effectiveness of adding Sativex® spray to spasticity care in Belgium: using bootstrapping instead of Monte Carlo simulation for probabilistic sensitivity analyses," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(5), pages 711-721, July.
    4. Kaitlyn Hastings & Clara Marquina & Jedidiah Morton & Dina Abushanab & Danielle Berkovic & Stella Talic & Ella Zomer & Danny Liew & Zanfina Ademi, 2022. "Projected New-Onset Cardiovascular Disease by Socioeconomic Group in Australia," PharmacoEconomics, Springer, vol. 40(4), pages 449-460, April.
    5. Andrea Marcellusi & Raffaella Viti & Loreta A. Kondili & Stefano Rosato & Stefano Vella & Francesco Saverio Mennini, 2019. "Economic Consequences of Investing in Anti-HCV Antiviral Treatment from the Italian NHS Perspective: A Real-World-Based Analysis of PITER Data," PharmacoEconomics, Springer, vol. 37(2), pages 255-266, February.
    6. Risha Gidwani & Louise B. Russell, 2020. "Estimating Transition Probabilities from Published Evidence: A Tutorial for Decision Modelers," PharmacoEconomics, Springer, vol. 38(11), pages 1153-1164, November.
    7. Round, Jeff, 2012. "Is a QALY still a QALY at the end of life?," Journal of Health Economics, Elsevier, vol. 31(3), pages 521-527.
    8. Xinyue Dong & Xiaoning He & Jing Wu, 2022. "Cost Effectiveness of the First‐in‐Class ARNI (Sacubitril/Valsartan) for the Treatment of Essential Hypertension in a Chinese Setting," PharmacoEconomics, Springer, vol. 40(12), pages 1187-1205, December.
    9. Joseph F. Levy & Marjorie A. Rosenberg, 2019. "A Latent Class Approach to Modeling Trajectories of Health Care Cost in Pediatric Cystic Fibrosis," Medical Decision Making, , vol. 39(5), pages 593-604, July.
    10. Jisoo A Kwon & Georgina M Chambers & Fabio Luciani & Lei Zhang & Shamin Kinathil & Dennis Kim & Hla-Hla Thein & Willings Botha & Sandra Thompson & Andrew Lloyd & Lorraine Yap & Richard T Gray & Tony B, 2021. "Hepatitis C treatment strategies in prisons: A cost-effectiveness analysis," PLOS ONE, Public Library of Science, vol. 16(2), pages 1-13, February.
    11. Qi Cao & Erik Buskens & Hans L. Hillege & Tiny Jaarsma & Maarten Postma & Douwe Postmus, 2019. "Stratified treatment recommendation or one-size-fits-all? A health economic insight based on graphical exploration," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(3), pages 475-482, April.
    12. Jorge Luis García & James J. Heckman, 2021. "Early childhood education and life‐cycle health," Health Economics, John Wiley & Sons, Ltd., vol. 30(S1), pages 119-141, November.
    13. Stephen Morris & Kurinchi S Gurusamy & Jessica Sheringham & Brian R Davidson, 2015. "Cost-Effectiveness Analysis of Endoscopic Ultrasound versus Magnetic Resonance Cholangiopancreatography in Patients with Suspected Common Bile Duct Stones," PLOS ONE, Public Library of Science, vol. 10(3), pages 1-12, March.
    14. Tushar Srivastava & Nicholas R. Latimer & Paul Tappenden, 2021. "Estimation of Transition Probabilities for State-Transition Models: A Review of NICE Appraisals," PharmacoEconomics, Springer, vol. 39(8), pages 869-878, August.
    15. Eleanor Heather & Katherine Payne & Mark Harrison & Deborah Symmons, 2014. "Including Adverse Drug Events in Economic Evaluations of Anti-Tumour Necrosis Factor-α Drugs for Adult Rheumatoid Arthritis: A Systematic Review of Economic Decision Analytic Models," PharmacoEconomics, Springer, vol. 32(2), pages 109-134, February.
    16. Manuel Gomes & Robert Aldridge & Peter Wylie & James Bell & Owen Epstein, 2013. "Cost-Effectiveness Analysis of 3-D Computerized Tomography Colonography Versus Optical Colonoscopy for Imaging Symptomatic Gastroenterology Patients," Applied Health Economics and Health Policy, Springer, vol. 11(2), pages 107-117, April.
    17. Isaac Corro Ramos & Maureen P. M. H. Rutten-van Mölken & Maiwenn J. Al, 2013. "The Role of Value-of-Information Analysis in a Health Care Research Priority Setting," Medical Decision Making, , vol. 33(4), pages 472-489, May.
    18. Chantal Guilhaume & Delphine Saragoussi & John Cochran & Clément François & Mondher Toumi, 2010. "Modeling stroke management: a qualitative review of cost-effectiveness analyses," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 11(4), pages 419-426, August.
    19. Theresa Tawiah & Kristian Schultz Hansen & Frank Baiden & Jane Bruce & Mathilda Tivura & Rupert Delimini & Seeba Amengo-Etego & Daniel Chandramohan & Seth Owusu-Agyei & Jayne Webster, 2016. "Cost-Effectiveness Analysis of Test-Based versus Presumptive Treatment of Uncomplicated Malaria in Children under Five Years in an Area of High Transmission in Central Ghana," PLOS ONE, Public Library of Science, vol. 11(10), pages 1-18, October.
    20. F. S. Mennini & Gianluca Fabiano & G. Favato & P. Sciattella & P. Bonanni & C. Pinto & A. Marcellusi, 2019. "Economic burden of HPV9-related diseases: a real-world cost analysis from Italy," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(6), pages 829-840, August.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:spr:pharme:v:36:y:2018:i:5:d:10.1007_s40273-018-0643-4. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.