Hakimi Zalmai, Kelleher Con, Aballéa Samuel, Maman Khaled, Nazir Jameel, Mankowski Colette, Odeyemi Isaac
Medical Affairs Department, Astellas Pharma Europe B.V, Leiden, The Netherlands.
Department of Obstetrics and Gynecology, Guy's and St. Thomas' NHS Foundation Trust, London, UK.
J Mark Access Health Policy. 2018 Mar 20;6(1):1438721. doi: 10.1080/20016689.2018.1438721. eCollection 2018.
To evaluate the cost-effectiveness of solifenacin 5 mg/day versus other oral antimuscarinic agents used for overactive bladder (OAB) from a UK National Health Service (NHS) perspective. In a Markov model, hypothetical patients received solifenacin 5 mg/day or a comparator antimuscarinic, after which they could switch to an alternative antimuscarinic. The model estimated incremental cost-effectiveness ratios (ICER), expressed as cost per quality-adjusted life year (QALY) over a 5-year period. Solifenacin 5 mg/day was the dominant treatment strategy (i.e., less costly and more effective) versus tolterodine extended-release (ER) 4 mg/day, fesoterodine 4 and 8 mg/day, oxybutynin ER 10 mg/day and solifenacin 10 mg/day, and was cost-effective (i.e., ICERs below the £30,000 per QALY threshold generally applied in the NHS) versus oxybutynin immediate release (IR) 10 mg/day, tolterodine IR 4 mg/day and trospium chloride 60 mg/day. The probability of solifenacin 5 mg/day being dominant/cost-effective at a willingness-to-pay threshold of £30,000 per QALY was 57-98%. Solifenacin 5 mg/day appears to be a cost-effective strategy for the treatment of OAB over a 5-year timeframe compared with other oral antimuscarinic agents in the UK. These findings are important for decision-makers considering the economic implications of selecting treatments for OAB.
从英国国家医疗服务体系（NHS）的角度评估每日5毫克索利那新与用于治疗膀胱过度活动症（OAB）的其他口服抗毒蕈碱药物的成本效益。在一个马尔可夫模型中，假设患者接受每日5毫克索利那新或一种对照抗毒蕈碱药物治疗，之后他们可以转而使用另一种抗毒蕈碱药物。该模型估计了增量成本效益比（ICER），以5年期间每质量调整生命年（QALY）的成本表示。与每日4毫克托特罗定缓释剂（ER）、4毫克和8毫克非索罗定、每日10毫克奥昔布宁ER以及每日10毫克索利那新相比，每日5毫克索利那新是主要治疗策略（即成本更低且更有效），并且与每日10毫克奥昔布宁速释剂（IR）、每日4毫克托特罗定IR以及每日60毫克氯化曲司氯铵相比具有成本效益（即ICER低于NHS通常采用的每QALY 30,000英镑的阈值）。在每QALY支付意愿阈值为30,000英镑时，每日5毫克索利那新占主导地位/具有成本效益的概率为57 - 98%。与英国其他口服抗毒蕈碱药物相比，在5年时间范围内，每日5毫克索利那新似乎是治疗OAB的一种具有成本效益的策略。这些发现对于考虑选择OAB治疗方法的经济影响的决策者而言很重要。
