COST-EFFECTIVENESS OF LINACLOTIDE- A VALUABLE OPTION IN THE TREATMENT OF IRRITABLE BOWEL SYNDROME
Author(s)
Almeida J, Vandewalle B, Félix J
Exigo Consultores, Lisbon, Portugal
OBJECTIVES: Constipation-predominant irritable bowel syndrome (IBS-C) affects more than 2% of the population carrying a heavy burden in developed countries and leading to significant losses in patients’ quality of life. Treatment goals are to provide relief of abdominal pain, restore the bowel transit and alleviate associated symptoms. Linaclotide has been shown to significantly improve abdominal and bowel symptoms in two phase III trials being the only EMA approved therapy indicated for the treatment of IBS-C. Therefore, this study aimed to perform a cost-effectiveness analysis comparing linaclotide with no active treatment for the treatment of IBS-C from the Portuguese societal perspective. METHODS: A Markov model was developed to simulate the natural course and treatment of the disease. Patient-level satisfaction data from linaclotide’s randomised clinical trials was used to define 4 health states: ‘Not Satisfied’, ‘Moderately Satisfied’, ‘Satisfied’ and ‘Dead’. These data were linked to utility scores based on patients’ responses to the EuroQol-5D questionnaire. Transitions between health states were assumed to occur every 4 weeks, with probabilities derived from observed efficacy data up to 20-weeks. Extrapolation beyond this period was based on last observation carried forward data. Effectiveness was measured in quality-adjusted life years (QALY). Only direct costs were incorporated. Resource utilization was estimated from a literature review. Unit costs came from official Portuguese databases and pricing lists. Time horizon was fixed at 10 years. Probabilistic sensitivity analysis was conducted with Monte Carlo simulations. RESULTS: A mean gain of 0.22 QALY (95%CI: [0.1; 0.35]) was estimated for each patient treated with linaclotide versus no treatment. Additionally, linaclotide utilization led to an overall average cost reduction of 402€ (95%CI: [-; 536]) thus representing a dominant option. CONCLUSIONS: When compared with no active treatment, linaclotide is a cost-saving and more effective therapeutic option for the treatment of IBS-C from the Portuguese societal perspective
Conference/Value in Health Info
2014-11, ISPOR Europe 2014, Amsterdam, The Netherlands
Value in Health, Vol. 17, No. 7 (November 2014)
Code
PGI21
Topic
Economic Evaluation
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
Gastrointestinal Disorders