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醋酸乌利司他用于子宫肌瘤术前管理:建模结果与成本

Ulipristal acetate for pre-operative management of uterine fibroids: Modeling outcomes and costs.

作者信息

Badiani Brigitta, Chiumente Marco, Messori Andrea

机构信息

Post-graduate School of Hospital Pharmacy, University of Firenze, Firenze, Italy.

Scientific Direction, SIFACT, Italian Society for Clinical Pharmacy and Therapeutics, Milano, Italy.

出版信息

Eur J Obstet Gynecol Reprod Biol. 2018 Mar;222:84-88. doi: 10.1016/j.ejogrb.2018.01.020. Epub 2018 Feb 3.

Abstract

OBJECTIVES

The aim of this study was to evaluate the pharmacoeconomic profile in Italy of preoperative treatment with ulipristal acetate at the dose of 5 mg/day for 13 weeks in comparison with placebo prior to surgical management of symptomatic uterine fibroids.

STUDY DESIGN

The pharmacoeconomic analysis was based on the calculation of incremental cost-effectiveness ratio (ICER). Effectiveness data were derived from the randomized-controlled trial PEARL-1, whilst costs data were retrieved from the published literature. A Markov model was employed to simulate the pattern of costs and two univariate sensitivity analyses tested the robustness of the results.

RESULTS

In comparison with placebo, ulipristal acetate 5 mg for presurgical therapy was estimated to be associated with an incremental cost of €351 per patient. Costs per patient were €3836 for ulipristal acetate vs €3485 for placebo. The incremental effectiveness was 0.01931 QALYs per patient (around 7 quality-adjusted days per patient). Hence, the cost effectiveness ratio was calculated to be €18,177 per QALY gained.

CONCLUSIONS

Preoperative use of ulipristal acetate 5 mg in patients with uterine fibroids has a favourable pharmacoeconomic profile.

摘要

目的

本研究旨在评估在意大利,与安慰剂相比,对于有症状的子宫肌瘤患者,术前使用每日5毫克醋酸乌利司他治疗13周的药物经济学情况。

研究设计

药物经济学分析基于增量成本效益比(ICER)的计算。有效性数据来自随机对照试验PEARL-1,而成本数据则从已发表的文献中获取。采用马尔可夫模型来模拟成本模式,并进行了两项单变量敏感性分析以检验结果的稳健性。

结果

与安慰剂相比,术前治疗使用5毫克醋酸乌利司他估计每位患者的增量成本为351欧元。醋酸乌利司他每位患者的成本为3836欧元,而安慰剂为3485欧元。增量有效性为每位患者0.01931个质量调整生命年(每位患者约7个质量调整日)。因此,计算得出的成本效益比为每获得一个质量调整生命年18,177欧元。

结论

子宫肌瘤患者术前使用5毫克醋酸乌利司他具有良好的药物经济学情况。

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