Cost-utility analysis and budget impact analysis of pegvisomant for the treatment of adult patients with acromegaly in Poland
Journal Title: JOURNAL OF HEALTH POLICY & OUTCOMES RESEARCH - Year 2018, Vol 2, Issue 2
Abstract
Background: The aim of this publication was to evaluate the cost-effectiveness and financial consequences of pegvisomant (PEG) in the treatment of adult patients with acromegaly, who have had an inadequate response to surgery and/or radiation therapy and in whom an appropriate medical treatment with somatostatin analogues (SSA) did not normalize IGF-1 concentrations or was not tolerated compared with SSA continuation. Methods: The Markov model constructed in TreeAge Pro with 45-year time horizon was used in the cost-utility analysis (CUA). Quality adjusted life years (QALY) were used as the measure of effectiveness. CUA was conducted from the perspective of the public payer for health services (Polish National Health Fund, PNHF) and from the patient’s and PNHF’s perspective. Budget impact analysis was performed in a 3-year time horizon from PNHF’s perspective. Two scenarios were compared: “present”, without reimbursement of PEG; “new”, after reimbursement of PEG. Results: The cost of gaining an additional QALY by replacing SSA with PEG is equal 742,724 PLN/ 714,800 PLN (172 470 €/ 165 986 €) from PNHF/PNHF+patient perspective. The annual expenditure of the PNHF’s budget in the first three years would increase by approximately 11.95 million PLN in the first, 26.39 million PLN in the second and 26.5 million in the third year of PEG reimbursement. Conclusion: The creation of drug program for acromegalic patients, in which reimbursement of PEG will be provided, will significantly influence the prognosis, course of the disease and improve the patient’s quality of life.
Authors and Affiliations
Ewa Borowiack, Magdalena Marzec, Anna Nowotarska, Katarzyna Policht, Małgorzata Konopka-Pliszka, Joanna Jarosz, Monika Borowiack
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