MODELING THE COST-EFFECTIVENESS OF ILAPRAZOLE VS. OMEPRAZOLE FOR THE TREATMENT OF NEWLY DIAGNOSED DUODENAL ULCER PATIENTS IN CHINA
Author(s)
Lu YJ1, Xu GX2, Lu WQ2, Liu Z2, Song Rl3, Xuan J4
1Shanghai Centennial Scientific Co.,Ltd, Shanghai, China, 2Livzon Pharmaceutical Group Inc., Shenzhen, China, 3China Pharmaceutical Innovation and Research Development Association, Beijing, China, 4Sun Yat-Sen University, Guangzhou, China
OBJECTIVES: To evaluate the cost-effectiveness of 10mg ilaprazole once daily vs. 20 mg omeprazole once daily to treat newly diagnosed duodenal ulcer patients in China. METHODS: A decision tree model was constructed and the treatment impact was projected up to one year. The CYP2C19 polymorphism distribution in the Chinese population, the respective cure rates in the CYP2C19 genotype subgroups, the impact of duodenal ulcer on utility, and drug related side effects data were obtained from literature. The total cost of medications were calculated to estimate treatment costs based on current drug retail prices in China. Expert survey was conducted when published data were not available to populate the model such as costs of the side effects. The main summary measure in this evaluation was incremental cost per quality-adjusted life-years (QALY) gained. Probabilistic sensitivity analysis was performed to determine the robustness of the results. RESULTS: Ilaprazole achieved a better overall efficacy, because it is less impacted by CYP2C19 genotype subgroups. Compared with omeprazole, ilaprazole achieved an incremental cost effectiveness ratio of ¥132,056 per QALY gained which is less than the 3 times of China average GDP per capital (2014). A subgroup analysis suggests Ilaprazole is most cost-effective in the CYP2C19 subpopulation of heterogeneous extensive metabolizer, which had the incremental cost effectiveness ratio of ¥57,810 per QALY gained. Probabilistic sensitivity analysis suggests that the results are robust with 97% probability that ilaprozole is consider cost effective when 3 times China average GDP per capital threshold is used. CONCLUSIONS: The cost-effectiveness analysis results demonstrated that ilaprazole would be considered cost-effective compared with omeprazole to treat newly diagnosed duodenal ulcer patient in China. When treating the duodenal ulcer patients who are CYP2C19 subpopulation of heterogeneous extensive metabolizer, ilaprazole is highly cost-effective, compared with omeprazole.
Conference/Value in Health Info
2015-11, ISPOR Europe 2015, Milan, Italy
Value in Health, Vol. 18, No. 7 (November 2015)
Code
PGI19
Topic
Economic Evaluation
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
Gastrointestinal Disorders