Geitona Maria, Karabela Pinelopi, Katsoulis Ioannis A, Kousoulakou Hara, Lyberopoulou Eleni, Bitros Eleftherios, Xaplanteris Loukas, Papanicolaou Sotiria
GlaxoSmithKline, Athens, Greece.
BMC Urol. 2014 Sep 26;14:78. doi: 10.1186/1471-2490-14-78.
The purpose of this study was to explore the budget impact of dutasteride plus tamsulosin fixed-dose combination (DUT + TAM FDC) versus tamsulosin monotherapy, in the treatment of patients with benign prostatic hyperplasia (BPH) from the perspective of the Greek healthcare insurance system.
A Microsoft Excel-based model was developed to estimate the financial consequences of adopting DUT + TAM FDC within the Greek healthcare setting. The model, compared six mutually exclusive health states in two alternative treatment options: current standard of care and the introduction of DUT + TAM FDC in the market. The model used clinical inputs from the CombAT study; data on resource use associated with the management of BPH in Greece were derived from expert panel, and unit cost data were derived from official reimbursement tariffs. A payer perspective was taken into account. As patient distribution data between public and private sectors are not available in Greece two scenarios were investigated, considering the whole eligible population in each scenario. A 4 year time horizon was taken into account and included treatment costs, number of transurethral resections of the prostate (TURPs) and acute urinary retention (AUR) episodes avoided.
The clinical benefit from the market adoption of DUT + TAM FDC in Greece was 1,758 TURPs and 972 episodes of AUR avoided cumulatively in a four year period. The increase in total costs from the gradual introduction of DUT + TAM FDC to the Greek healthcare system ranges from €1.3 million in the first year to €5.8 million in the fourth year, for the public sector, and €1.2 million to €4.0 million, for the private sector. This represents an increase of 1.91% to 7.94% for the public sector and 1.10% 3.29% in the private sector, during the 4-year time horizon.
Budget impact analysis (BIA) results indicated that the gradual introduction of DUT + TAM FDC, would increase the overall budget of the disease, however providing better clinical outcomes. DUT + TAM FDC drug acquisition cost is partly offset by the reduction in the costs associated with the treatment of the disease.
本研究旨在从希腊医疗保险系统的角度，探讨度他雄胺联合坦索罗辛固定剂量复方制剂（DUT+TAM FDC）与坦索罗辛单药治疗相比，在治疗良性前列腺增生（BPH）患者方面的预算影响。
开发了一个基于Microsoft Excel的模型，以估计在希腊医疗环境中采用DUT+TAM FDC的财务后果。该模型比较了两种替代治疗方案中的六种相互排斥的健康状态：当前的护理标准和DUT+TAM FDC在市场上的引入。该模型使用了CombAT研究的临床数据；希腊与BPH管理相关的资源使用数据来自专家小组，单位成本数据来自官方报销费率。考虑了支付方的观点。由于希腊没有公共和私营部门之间的患者分布数据，因此研究了两种情况，每种情况都考虑了整个符合条件的人群。考虑了4年的时间范围，包括治疗成本、避免的经尿道前列腺切除术（TURP）数量和急性尿潴留（AUR）发作次数。
在希腊市场采用DUT+TAM FDC的临床益处是，在四年期间累计避免了1758例TURP和972次AUR发作。对于公共部门，将DUT+TAM FDC逐步引入希腊医疗系统导致的总成本增加，从第一年的130万欧元到第四年的580万欧元不等；对于私营部门，从120万欧元到400万欧元不等。这意味着在4年时间范围内，公共部门增加了1.91%至7.94%，私营部门增加了1.10%至3.29%。
预算影响分析（BIA）结果表明，逐步引入DUT+TAM FDC会增加该疾病的总体预算，但能提供更好的临床结果。DUT+TAM FDC的药物采购成本部分被与该疾病治疗相关的成本降低所抵消。
