Document Detail


Cost-effectiveness analysis of pancreatin minimicrospheres in patients with pancreatic exocrine insufficiency due to chronic pancreatitis.
MedLine Citation:
PMID:  23043594     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Abstract Objective. Chronic pancreatitis (CP) is the most common cause of pancreatic exocrine insufficiency (PEI). Management of PEI due to CP is achieved through lifelong treatment with pancreatic enzyme replacement therapy (PERT). To our knowledge no cost-effectiveness analysis on the benefit of PERT in CP patients with PEI has been performed to date. The objective of this analysis was to examine the cost-effectiveness of Creon (pancreatin minimicrospheres [MMS]), one of the main PERTs available in Poland, in treating patients with CP-related PEI. Methods. The cost-effectiveness of pancreatin MMS in the treatment of patients with CP-related PEI versus no PERT treatment was estimated using a decision analysis based on clinical data from relevant studies. The model horizon was 20 years. Main outcomes included the percentage of patients with controlled PEI, survival, total medical costs, number of quality-adjusted life years (QALYs), and the incremental cost-effectiveness ratio (ICER). All costs were analysed from the Polish payer perspective. Results. The model included clinical data from 176 patients treated in 5 pancreatin MMS randomised trials. Treatment with pancreatin MMS resulted in a considerably higher proportion of patients with controlled PEI compared to those not treated with any PERT. Over a horizon of 20 years, the total treatment cost and the ICER for pancreatin MMS was €8,223 and €6,312 per QALY respectively. Limitations. Important limitations include the lack of long-term and comparative clinical data available. The use of "no PERT treatment" as a comparator against pancreatin MMS treatment may not accurately reflect current practice in Poland. Conclusions. Treatment of CP-related PEI with pancreatin MMS is cost-effective from a Polish payer perspective, with an ICER below the accepted 'willingness to pay' threshold of 3 times gross domestic product (GDP) per capita. These results are likely to apply to other European countries.
Authors:
J Morawski; A Prüfert; A van Engen; D Foerster; S Sander-Struckmeier; E Małecka-Panas; R Pezzilli
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-9
Journal Detail:
Title:  Journal of medical economics     Volume:  -     ISSN:  1941-837X     ISO Abbreviation:  J Med Econ     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-9     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9892255     Medline TA:  J Med Econ     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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