OnabotulinumtoxinA in the treatment of overactive bladder: a cost-effectiveness analysis versus best supportive care in England and Wales

被引:10
|
作者
Freemantle, Nick [1 ]
Khalaf, Kristin [2 ]
Loveman, Clara [3 ]
Stanisic, Sanja [4 ]
Gultyaev, Dmitry [5 ]
Lister, Johanna [5 ]
Drake, Marcus [6 ,7 ]
机构
[1] UCL Med Sch, Dept Primary Care & Populat Hlth, Rowland Hill St, London NW3 2PF, England
[2] Allergan Pharmaceut Inc, 2525 Dupont Dr, Irvine, CA 92612 USA
[3] Marlow Int, Allergan Holdings Ltd, Marlow SL7 1YL, Bucks, England
[4] LA SER ANALYT, Corso Porta Nuova 34, I-20121 Milan, Italy
[5] LA SER ANALYT, Meeraner Pl 1, D-79539 Lorrach, Germany
[6] Univ Bristol, Sch Clin Sci, Southmead Rd, Bristol BS10 5NB, Avon, England
[7] Univ Bristol, Bristol Urol Inst, Southmead Rd, Bristol BS10 5NB, Avon, England
来源
EUROPEAN JOURNAL OF HEALTH ECONOMICS | 2016年 / 17卷 / 07期
关键词
Overactive bladder; OnabotulinumtoxinA; Incontinence; Cost-effectiveness; QUALITY-OF-LIFE; SACRAL NERVE-STIMULATION; URINARY-INCONTINENCE; BOTULINUM TOXIN; PSYCHOMETRIC PERFORMANCE; EXTENDED-RELEASE; A INJECTIONS; NEUROMODULATION; HEALTH; EQ-5D;
D O I
10.1007/s10198-015-0737-2
中图分类号
F [经济];
学科分类号
02 ;
摘要
The cost-effectiveness of onabotulinumtoxinA (BOTOXA (R)) 100 U + best supportive care (BSC) was compared with BSC alone in the management of idiopathic overactive bladder in adult patients who are not adequately managed with anticholinergics. BSC included incontinence pads and, for a proportion of patients, anticholinergics and/or occasional clean intermittent catheterisation. A five-state Markov model was used to estimate total costs and outcomes over a 10-year period. The cohort was based on data from two placebo-controlled trials and a long-term extension study of onabotulinumtoxinA. After discontinuation of initial treatment, a proportion of patients progressed to downstream sacral nerve stimulation (SNS). Cost and resource use was estimated from a National Health Service perspective in England and Wales using relevant reference sources for 2012 or 2013. Results showed that onabotulinumtoxinA was associated with lower costs and greater health benefits than BSC in the base case, with probabilistic sensitivity analysis indicating an 89 % probability that the incremental cost-effectiveness ratio would fall below A 20,000 pound. OnabotulinumtoxinA remained dominant over BSC in all but two scenarios tested; it was also economically dominant when compared directly with SNS therapy. In conclusion, onabotulinumtoxinA appears to be a cost-effective treatment for overactive bladder compared with BSC alone.
引用
收藏
页码:911 / 921
页数:11
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