scholarly journals Cost-Effectiveness Analysis of Treatment for Severe Eosinophilic Asthma in Adults: Mepolizumab and Omalizumab

2019 ◽  
pp. 74-85
Author(s):  
Alexander Tolkushin ◽  
Nalalya Pogudina ◽  
Dmitry Ivanov ◽  
Irina Demko
Keyword(s):  
Cost Effectiveness ◽  
Risk Ratio ◽  
Meta Analysis ◽  
Unit Cost ◽  
Medical Costs ◽  
Cost Effectiveness Analysis ◽  
Eosinophilic Asthma ◽  
Severe Eosinophilic Asthma ◽  
Direct Medical Costs ◽  
Effectiveness Analysis

Objective: Based on the cost-effectiveness analysis (CEA) to determine economic and clinical consequences of using mepolizumab instead of omalizumab in adults with severe eosinophilic asthma, when omalizumab is administered once every 2 weeks or mepolizumab is administered once every 4 weeks. Methods: Effectiveness and safety analysis was conducted based on the published network meta-analysis, because head-to-head clinical trials of omalizumab versus mepolizumab were not identified during targeted scientific literature search. Direct medical costs were calculated using information from the register of manufacturers` maximum selling prices for vital and essential drugs (VED), instructions for medical use, the unit cost of healthcare services. Results: Effectiveness and safety of the compared drugs were determined based on the results of the network meta-analysis. Frequency of clinically significant asthma exacerbations (risk ratio = 0,19; 95% CI: 0,02–2,32) and withdrawals due to adverse events (risk ratio = 0,05; 95% CI: 0,002–0,95). Therefore, despite the tendency to mepolisumab benefits, it was concluded that there are no statistically significant differences in the effectiveness and safety of the compared drugs due to the insufficient statistical power of the result. Direct medical costs were 870130 rubles and 1852063 rubles for mepolizumab and omalizumab respectively. Saving of direct medical costs for mepolizumab treatment was 959170 rubles per patient per year or 52%. Conclusion: treatment with mepolizumab versus omalizumab in patients with severe eosinophilic asthma, when omalizumab is administered once every 2 weeks or mepolizumab is administered once every 4 weeks, leads to saving of direct medical costs for drug treatment.

scholarly journals Cost-effectiveness analysis of Anti–IL-5 therapies of severe eosinophilic asthma in Spain

2021 ◽  
pp. 1-1
Author(s):  
Francisco Javier González-Barcala ◽  
Xavier Muñoz-Gall ◽  
Esther Mariscal ◽  
Andrea García ◽  
Shibing Yang ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Cost Effectiveness Analysis ◽  
Eosinophilic Asthma ◽  
Severe Eosinophilic Asthma ◽  
Effectiveness Analysis

scholarly journals Clinical and economic comparison of utilization of reslizumab, mepolizumab and benralizumab in the treatment of severe eosinophilic asthma

2020 ◽  
Vol 92 (12) ◽  
pp. 172-179
Author(s):  
S. K. Zyryanov ◽  
S. N. Avdeev ◽  
D. A. Ivanov ◽  
M. V. Zhuravleva ◽  
N. P. Kniajeskaia ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Severe Asthma ◽  
Body Mass ◽  
Budget Impact ◽  
Cost Effectiveness Analysis ◽  
Cost Effectiveness Ratio ◽  
Eosinophilic Asthma ◽  
Severe Eosinophilic Asthma ◽  
Effectiveness Analysis ◽  
The Cost

During last few years, the approaches to the management of patients with severe asthma have been revised. Monoclonal antibodies (MABs), inhibitors of interleukin-5 (reslizumab, mepolizumab, benralizumab) have been recently introduced for the treatment of severe eosinophilic asthma. The mentioned drugs were approved in Russia and included into the list of Vitally Essential Drugs. Aim.The aim of this study was to compare the clinical and economic consequences of the use of biological agents that antagonize IL-5 in the treatment of severe eosinophilic asthma in adults. Materials and methods.Two methods of clinical and economic research were used: assessment of the cost-effectiveness ratio and analysis of the budget impact. The effectiveness of the drugs was assessed using indirect comparison; special attention was paid to comparability of the patient groups in the studies chosen for such an assessment. Two approaches were used for calculation of the cost of therapy for severe asthma: using DRGs (applicable to most regions of Russia), and without the use of DRGs, which is relevant only for few Russian regions. Results.Basing on the data obtained from a budget impact study without the use of DRG, it was shown that reslizumab was dominating for patients with body mass of up to 70 kg, while for the patients with body mass of 70 to 110 kg, mepolizumab was dominating, while utilization of reslizumab appeared to be somewhat more expensive. In the group of patients with body mass over 110 kg, mepolizumab also was dominating. The calculation of the cost-effectiveness ratio (CER) showed that reslizumab appeared to be dominating over two other MABs, The results of the study using the DRG demonstrated that the cost of an annual course of benralizumab in most cases in Russia would exceed the amount that can be compensated by Territorial Funds for Mandatory Medical Insurance to a healthcare institution for therapy of bronchial asthma in one adult patient with genetically engineered drugs. Therefore, further comparisons were made for reslizumab and mepolizumab only. Analysis of the impact on the budget demonstrated that treatment with reslizumab and mepolizumab would represent a similar burden for the budget. When applying cost-effectiveness analysis, reslizumab was more cost-effective than mepolizumab (regardless of patient body mass). Conclusion.Thus, the results of the clinical and economic study suggested that, basing on the cost-effectiveness analysis, reslizumab appeared to be the dominant IL-5 antagonist (regardless of body mass if DRG approach was used and in patients with body mass up to 110 kg, if such an approach was not used). Basing on budget impact analysis, calculations without use of DRG approach showed superiority of reslizumab over mepolizumab and benralizumab for the patients with body mass up to 70 kg and the DRG-based approach showed equal burden for the budget for reslizumab and mepolizumab for the patients with any body mass.

scholarly journals Pharmacoeconomic Analysis of Using Different Types of Monofocal Intraocular Lenses for Cataract Surgery in Russia

2019 ◽  
Vol 16 (1) ◽  
pp. 131-141
Author(s):  
I. S. Krysanov ◽  
V. S. Krysanova ◽  
V. Yu. Ermakova
Keyword(s):  
Cost Effectiveness ◽  
Cataract Surgery ◽  
Medical Costs ◽  
Cost Effectiveness Analysis ◽  
Intraocular Lenses ◽  
System Perspective ◽  
Direct Medical Costs ◽  
Effectiveness Analysis ◽  
Different Types ◽  
Monofocal Iol

Purpose: To perform cost-effectiveness analysis of using different types of monofocal intraocular lenses (IOL) for cataract surgery in adults in Russian Federation. Materials and methods. MS Excel based model of medical care patients with cataract has been developed for 1 patient undergoing surgery treatment. “cost-effectiveness” and “budget impact” analyses (BIA) were used to measure the costs associated with cataract treatment with different types of monofocal IOLs for the state budget. Direct medical costs included IOLs cost, treatment of PCO with neodymium-doped uttrium aluminium garnet laser capsulotomy (Nd:YAG), side effects treatment associated with Nd:YAG and were calculated from the Russian healthcare system perspective. Results. Cost-effectiveness analysis among monofocal IOLs demonstrated that the lowest costs for 1 case of successful cataract surgery followed by implantation of the IOL are connected with the use of the AcrySof® Single Piece model — 4,938 rubles, the largest costs — using the Tecnis® One model — 11,753.5 rubles. The use of others hydrophobic IOLs on the AcrySof® platform demonstrated economic feasibility, analyzed models have costs for 1 effective cataract treatment -AcrySof® IQ 9,858 rubles, AcrySof® Natural 6,452 rubles. The conducted BIA has showed that direct medical costs for surgical treatment of cataracts with the implantation of monofocal IOLs from different manufacturers for 100 patients amount to 708,121 rubles. If ua monofocal IOL are used alone on an AcrySof® platform, the cost will be 691,261 rubles, the difference is in favor of monofocal IOL on an AcrySof® platform — 16,860 rubles. Conclusion. Using AcrySof® IOLs for cataract surgery in adult patients is an effective and an economically justified treatment option in Russia Federation.

Assessing the value of mepolizumab for severe eosinophilic asthma: a cost-effectiveness analysis

2017 ◽  
Vol 118 (2) ◽  
pp. 220-225 ◽  
Author(s):  
Melanie D. Whittington ◽  
R. Brett McQueen ◽  
Daniel A. Ollendorf ◽  
Jeffrey A. Tice ◽  
Richard H. Chapman ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Cost Effectiveness Analysis ◽  
Eosinophilic Asthma ◽  
Severe Eosinophilic Asthma ◽  
Effectiveness Analysis

scholarly journals Very-low-dose aspirin and surveillance colonoscopy is cost-effective in secondary prevention of colorectal cancer in individuals with advanced adenomas: network meta-analysis and cost-effectiveness analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sajesh K. Veettil ◽  
Siang Tong Kew ◽  
Kean Ghee Lim ◽  
Pochamana Phisalprapa ◽  
Suresh Kumar ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cost Effectiveness ◽  
Secondary Prevention ◽  
Low Dose ◽  
Meta Analysis ◽  
Cost Effective ◽  
Cost Effectiveness Analysis ◽  
Surveillance Colonoscopy ◽  
Combination Strategy ◽  
Effectiveness Analysis

Abstract Background Individuals with advanced colorectal adenomas (ACAs) are at high risk for colorectal cancer (CRC), and it is unclear which chemopreventive agent (CPA) is safe and cost-effective for secondary prevention. We aimed to determine, firstly, the most suitable CPA using network meta-analysis (NMA) and secondly, cost-effectiveness of CPA with or without surveillance colonoscopy (SC). Methods Systematic review and NMA of randomised controlled trials were performed, and the most suitable CPA was chosen based on efficacy and the most favourable risk–benefit profile. The economic benefits of CPA alone, 3 yearly SC alone, and a combination of CPA and SC were determined using the cost-effectiveness analysis (CEA) in the Malaysian health-care perspective. Outcomes were reported as incremental cost-effectiveness ratios (ICERs) in 2018 US Dollars ($) per quality-adjusted life-year (QALY), and life-years (LYs) gained. Results According to NMA, the risk–benefit profile favours the use of aspirin at very-low-dose (ASAVLD, ≤ 100 mg/day) for secondary prevention in individuals with previous ACAs. Celecoxib is the most effective CPA but the cardiovascular adverse events are of concern. According to CEA, the combination strategy (ASAVLD with 3-yearly SC) was cost-saving and dominates its competitors as the best buy option. The probability of being cost-effective for ASAVLD alone, 3-yearly SC alone, and combination strategy were 22%, 26%, and 53%, respectively. Extending the SC interval to five years in combination strategy was more cost-effective when compared to 3-yearly SC alone (ICER of $484/LY gain and $1875/QALY). However, extending to ten years in combination strategy was not cost-effective. Conclusion ASAVLD combined with 3-yearly SC in individuals with ACAs may be a cost-effective strategy for CRC prevention. An extension of SC intervals to five years can be considered in resource-limited countries.

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