Buendia Jefferson Antonio, Patino Diana Guerrero, Lindarte Erika Fernanda
Research Group in Pharmacology and Toxicology"INFARTO". Department of Pharmacology and Toxicology, University of Antioquia, Medellin, Colombia.
Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Expert Rev Pharmacoecon Outcomes Res. 2023 Jul-Dec;23(8):967-973. doi: 10.1080/14737167.2023.2233698. Epub 2023 Jul 7.
Despite the increasing evidence supporting the efficacy of ambrisentan and bosentan in improving functional classes among pediatric patients with pulmonary arterial hypertension (PAH), there is a lack of information regarding their cost implications. Therefore, the objective of this study is to assess the cost-utility of bosentan compared to ambrisentan for the treatment of pediatric patients with PAH in Colombia.
We employed a Markov model to estimate the costs and quality-adjusted life-years (QALYs) associated with the use of ambrisentan or bosentan in pediatric patients diagnosed with pulmonary arterial hypertension (PAH). To ensure the reliability of our findings, we conducted sensitivity analyses to assess the robustness of the model. In our cost-effectiveness analysis, we evaluated the outcomes at a willingness-to-pay (WTP) threshold of US$5,180.
The expected annual cost per patient receiving ambrisentan was estimated to be $16,055 (95% CI 15,937 -16,172), while for bosentan it was $14,503 (95% CI 14,489 -14,615). The QALYs per person estimated for ambrisentan were 0.39 (95% CI 0.381-0.382), whereas for bosentan it was 0.40 (95% CI 0.401-0.403).
Our economic evaluation shows that ambrisentan is not cost-effective regarding bosentan to in treating pulmonary arterial hypertension in C.
尽管越来越多的证据支持安立生坦和波生坦在改善儿童肺动脉高压（PAH）患者功能分级方面的疗效，但关于它们的成本影响却缺乏相关信息。因此，本研究的目的是评估在哥伦比亚，与安立生坦相比，波生坦治疗儿童PAH患者的成本效益。
我们采用马尔可夫模型来估计在诊断为肺动脉高压（PAH）的儿童患者中使用安立生坦或波生坦的成本和质量调整生命年（QALY）。为确保研究结果的可靠性，我们进行了敏感性分析以评估模型的稳健性。在成本效益分析中，我们在支付意愿（WTP）阈值为5180美元的情况下评估结果。
预计接受安立生坦治疗的每位患者每年成本估计为16,055美元（95%CI 15,937 - 16,172），而波生坦为14,503美元（95%CI 14,489 - 14,615）。安立生坦估计的人均QALY为0.39（95%CI 0.381 - 0.382），而波生坦为0.40（95%CI 0.401 - 0.403）。
我们的经济评估表明，在哥伦比亚治疗肺动脉高压方面，与波生坦相比，安立生坦不具有成本效益。
