Cost-Utility Analysis of Bosentan Versus Iloprost in Korean Patients with Pulmonary Arterial Hypertension

우리나라 폐동맥고혈압환자에 대한 Bosentan과 Iloprost의 비용-효용 분석

  • Received : 2009.07.17
  • Accepted : 2010.02.18
  • Published : 2010.04.30

Abstract

This study was conducted to analyze cost-utility of bosentan versus iloprost indicated for pulmonary arterial hypertension (PAH) in a Korean healthcare setting from a payer's perspective. We constructed a Markov model to estimate total costs and outcomes for 1-year time horizon in a hypothetical cohort of 50-year-old patients with PAH. Base analysis showed that bosentan resulted in KW 5.5 billions saving and 18 quality-adjusted life year (QALY) gains per 100 patients compared to iloprost. Bosentan as a dominant strategy was found to be robust through various sensitivity analyses.

Keywords

Acknowledgement

Supported by : 악텔리온파마수티컬스코리아(주)

References

  1. Rubin, L. J. and Badesch, D. B. : Evaluation and management of the patient with pulmonary arterial hypertension. Ann. Intern. Med. 143, 282 (2005). https://doi.org/10.7326/0003-4819-143-4-200508160-00009
  2. The Task Force on Diagnosis and Treatment of Pulmonary Arterial Hypertension of the European Society of Cardiology. : Guidelines on diagnosis and treatment of pulmonary arterial hypertension. European Heart Journal 25, 2243 (2004). https://doi.org/10.1016/j.ehj.2004.09.014
  3. Pulmonary Hypertension Association. Available at: http://www.phassociation.org/Learn/What-is-PH/index.asp. (Accessed June 23, 2009).
  4. American Lung Association Lung Disease Data 2008 : Pulmonary arterial hypertension. Available at: http:// www.lungusa.org/atf/cf/%7B7a8d42c2-fcca-4604-8ade- 7f5d5e762256%7D/ALA_LDD08_PAH_FINAL.PDF. (Accessed June 18, 2009).
  5. Chaouat, A., Gomez, E., Canuet, M., Weitzenblum, E. and Chabot, F. : Clinical classification and epidemiology of pulmonary arterial hypertension. Rev Prat. 58, 1991 (2008).
  6. Lee, S. H. and Rubin, L. J. : Current treatment strategies for pulmonary arterial hypertension. J. Intern. Med. 258, 199 (2005). https://doi.org/10.1111/j.1365-2796.2005.01542.x
  7. D'Alonzo, G. E., Barst, R. J., Ayres, S. M, Bergofsky, E. H., Brundage, B. H., Detre, K. M., Fishman, A. P., Goldring, R. M., Groves, B. M. and Kernis, J. T. : Survival in patients with primary pulmonary hypertension. Results from a national prospective registry. Ann. Intern. Med. 115, 343 (1991). https://doi.org/10.7326/0003-4819-115-5-343
  8. 최혜숙, 이상도 : 폐동맥고혈압에서 폐혈관계 작용약물. Tuberculosis and Respiratory Diseases. 60, 142 (2006). https://doi.org/10.4046/trd.2006.60.2.142
  9. McLaughlin, V. V. and McGoon, M. D. : Pulmonary arterial hypertension. Circulation 114, 1417 (2006). https://doi.org/10.1161/CIRCULATIONAHA.104.503540
  10. Rubin, L. J., Badesch, D. B., Barst, R. J., Galie, N., Black, C. M., Keogh, A., Pulido, T., Frost, A., Roux, S., Leconte, I., Landzberg, M. and Simonneau, G. : Bosentan therapy for pulmonary arterial hypertension. N. Engl. J. Med. 346, 896 (2002). https://doi.org/10.1056/NEJMoa012212
  11. Raja, S. G. and Dreyfus, G. D. : Current status of bosentan for treatment of pulmonary hypertension. Ann. Card. Anaesth. 11, 6 (2008). https://doi.org/10.4103/0971-9784.38443
  12. Sohn, D. W., Kim, H. K., Kim, M. A., Song, W. and Noh, C. I. : Beneficial and adverse effects of bosentan treatment in Korean patients with pulmonary artery hypertension. Korean Circ. J. 39, 105 (2009). https://doi.org/10.4070/kcj.2009.39.3.105
  13. 식품의약품안전청. 의약품정보. Available at: http://ezdrug.kfda. go.kr/kfda2 (Accessed June 20, 2009).
  14. 한국희귀의약품센터. Available at: http://www.kodc.or.kr/search/ srch_ac_disease.asp?code=00050 (Accessed June 22, 2009).
  15. Olschewski, H., Simonneau, G., Galie, N., Higenbottam, T., Naeije, R., Rubin, L. J., Nikkho, S., Speich, R., Hoeper, M. M., Behr, J., Winkler, J., Sitbon, O., Popov, W., Ghofrani, H. A., Manes, A., Kiely, D. G., Ewert, R., Meyer, A., Corris, P. A., Delcroix, M., Gomez-Sanchez, M., Siedentop, H. and Seeger, W. : Aerosolized Iloprost Randomized Study Group. Inhaled iloprost for severe pulmonary hypertension. N. Engl. J. Med. 347, 322 (2002). https://doi.org/10.1056/NEJMoa020204
  16. Actelion Pharmaceuticals Ltd. : A Double-blind, Randomized, Placebo-controlled Study to Assess the Effects of Po 47-0203 (Bosentan) on Exercise Capacity in Patients with Pulmonary Arterial Hypertension. AC-052-352 Final Study Report (October 3, 2001).
  17. Dolan, P. : Modeling valuation for EuroQol health states. Med. Care. 35, 1095 (1997). https://doi.org/10.1097/00005650-199711000-00002
  18. Highland, K. B., Strange, C., Mazur, J. and Simpson, K. N. : Treatment of pulmonary arterial hypertension: a preliminary decision analysis. Chest. 124, 2087 (2003). https://doi.org/10.1378/chest.124.6.2087
  19. 건강보험심사평가원. 약제급여목록 및 상한금액표, 2008년 7월.
  20. 대한의사협회. 건강보험요양급여비용, 2008년 1월.
  21. Kenyon, K. W. and Nappi, J. M. : Bosentan for the treatment of pulmonary arterial hypertension. Ann. Pharmacother. 37, 1055 (2003). https://doi.org/10.1345/aph.1C256