Cost-effectiveness of ursodeoxycholic acid therapy in primary biliary cirrhosis

Citation
T. Pasha et al., Cost-effectiveness of ursodeoxycholic acid therapy in primary biliary cirrhosis, HEPATOLOGY, 29(1), 1999, pp. 21-26
Citations number
21
Categorie Soggetti
Gastroenerology and Hepatology","da verificare
Journal title
HEPATOLOGY
ISSN journal
02709139 → ACNP
Volume
29
Issue
1
Year of publication
1999
Pages
21 - 26
Database
ISI
SICI code
0270-9139(199901)29:1<21:COUATI>2.0.ZU;2-G
Abstract
Ursodeoxycholic acid (UDCA) is a safe and effective treatment for patients with primary biliary cirrhosis (PBC), but the cost of this drug has raised concerns regarding cost-effectiveness. The aim of our study was to determin e the cost-effectiveness of UDCA in PBC. We compared the costs and outcomes of managing PBC patients with and without UDCA. From two previously publis hed trials, the effectiveness of UDCA was determined by comparing the annua l reduction in the development of ascites, varices, variceal bleeding, ence phalopathy, liver transplantation, and death between the treatment groups. Average annual costs for each of these events were estimated based on liter ature and institutional data. Approximately twice as many major events occu rred in the placebo group compared with the UDCA group. The relative risk ( RR) of liver transplantation (1.95; 95% CI: 1.14-3.68) and development of e sophageal varices (3.11; 95% CI: 1.57-10.65) were significantly higher in t he placebo group compared with the UDCA group. There were no significant in creases in the RR of ascites, variceal bleeding, encephalopathy, or death b etween the two groups. Based on the estimated annual cost of managing these events and the annual costs of UDCA ($2,500), there was an annual cost sav ings per patient of $1,372. Compared with the placebo group, patients recei ving UDCA had a lower incidence of major complications and lower medical ca re costs.