Cost-Utility Analysis of Drug Treatments in Patients with Polypoidal Choroidal Vasculopathy in Thailand

Sermsiri Sangroongruangsri,1 Usa Chaikledkaew,1,2 Prut Hanusaha,3 Tanapat Ratanapakorn,4 Paisan Ruamviboonsuk5 1Social and Administrative Pharmacy Division, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand; 2Mahidol University Health Technology Assessment (MUHTA) Gr...

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Autores principales:	Sangroongruangsri S, Chaikledkaew U, Hanusaha P, Ratanapakorn T, Ruamviboonsuk P
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	pcv verteporfin anti-vegf agent retinal disease economic evaluation thailand Medicine (General) R5-920 Therapeutics. Pharmacology RM1-950
Acceso en línea:	https://doaj.org/article/67b022bcc6ad4fccbb614ba25aaf8fef
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spelling	oai:doaj.org-article:67b022bcc6ad4fccbb614ba25aaf8fef2021-11-11T18:22:26ZCost-Utility Analysis of Drug Treatments in Patients with Polypoidal Choroidal Vasculopathy in Thailand1178-6981https://doaj.org/article/67b022bcc6ad4fccbb614ba25aaf8fef2021-11-01T00:00:00Zhttps://www.dovepress.com/cost-utility-analysis-of-drug-treatments-in-patients-with-polypoidal-c-peer-reviewed-fulltext-article-CEORhttps://doaj.org/toc/1178-6981Sermsiri Sangroongruangsri,1 Usa Chaikledkaew,1,2 Prut Hanusaha,3 Tanapat Ratanapakorn,4 Paisan Ruamviboonsuk5 1Social and Administrative Pharmacy Division, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand; 2Mahidol University Health Technology Assessment (MUHTA) Graduate Program, Mahidol University, Bangkok, Thailand; 3Department of Ophthalmology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; 4Department of Ophthalmology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; 5Department of Ophthalmology, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, ThailandCorrespondence: Usa Chaikledkaew Tel +662-644-8679 ext 5317Fax +662-644-8694Email usa.chi@mahidol.ac.thPurpose: The aim of this study was to estimate the cost-utility and budget impact of pharmacological treatments for the eye with polypoidal choroidal vasculopathy (PCV) in Thailand.Methods: A Markov model-based cost-utility analysis (CUA) and budget impact analysis were conducted. The lifetime cost and outcomes of PCV treatments were estimated. We discounted costs and outcomes at 3% per annum. Parameters were estimated using data from published literatures, local cost and utility data, and epidemiology data among Thai patients. Univariate and probabilistic sensitivity analyses were performed to account for parameter uncertainty.Results: Intravitreal bevacizumab (IVB) resulted in the lowest lifetime cost, followed by IVB plus verteporfin photodynamic therapy (IVB+vPDT) and intravitreal aflibercept (IVA). The combination of IVB or intravitreal ranibizumab (IVR) and verteporfin photodynamic therapy (IVB+vPDT or IVR+vPDT) yielded the highest quality-adjusted life-years (QALY). When compared with IVB from a societal perspective, the incremental cost-effectiveness ratio for patients with PCV receiving IVB+vPDT, IVR+vPDT, IVA were 10,304; 54,135; and 82,738 the United States dollar (USD) per QALY gained, respectively. At the Thai societal willingness to pay threshold of 4884 USD, IVB had the highest probability of being cost-effective (99%) followed by IVB+vPDT (1%). IVB+vPDT could be a cost-effective strategy and required a budget of 12.61 million USD over five fiscal years when the price of verteporfin reduced by approximately 45%.Conclusion: None of the drug treatments for PCV was cost-effective in the Thai context. The decreased price of verteporfin is required to support the inclusion of IVB+vPDT in the Thai National List of Essential Medicines for the treatment of PCV.Keywords: PCV, verteporfin, anti-VEGF agent, retinal disease, economic evaluation, ThailandSangroongruangsri SChaikledkaew UHanusaha PRatanapakorn TRuamviboonsuk PDove Medical Pressarticlepcvverteporfinanti-vegf agentretinal diseaseeconomic evaluationthailandMedicine (General)R5-920Therapeutics. PharmacologyRM1-950ENClinicoEconomics and Outcomes Research, Vol Volume 13, Pp 917-926 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	pcv verteporfin anti-vegf agent retinal disease economic evaluation thailand Medicine (General) R5-920 Therapeutics. Pharmacology RM1-950
spellingShingle	pcv verteporfin anti-vegf agent retinal disease economic evaluation thailand Medicine (General) R5-920 Therapeutics. Pharmacology RM1-950 Sangroongruangsri S Chaikledkaew U Hanusaha P Ratanapakorn T Ruamviboonsuk P Cost-Utility Analysis of Drug Treatments in Patients with Polypoidal Choroidal Vasculopathy in Thailand
description	Sermsiri Sangroongruangsri,1 Usa Chaikledkaew,1,2 Prut Hanusaha,3 Tanapat Ratanapakorn,4 Paisan Ruamviboonsuk5 1Social and Administrative Pharmacy Division, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand; 2Mahidol University Health Technology Assessment (MUHTA) Graduate Program, Mahidol University, Bangkok, Thailand; 3Department of Ophthalmology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; 4Department of Ophthalmology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; 5Department of Ophthalmology, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, ThailandCorrespondence: Usa Chaikledkaew Tel +662-644-8679 ext 5317Fax +662-644-8694Email usa.chi@mahidol.ac.thPurpose: The aim of this study was to estimate the cost-utility and budget impact of pharmacological treatments for the eye with polypoidal choroidal vasculopathy (PCV) in Thailand.Methods: A Markov model-based cost-utility analysis (CUA) and budget impact analysis were conducted. The lifetime cost and outcomes of PCV treatments were estimated. We discounted costs and outcomes at 3% per annum. Parameters were estimated using data from published literatures, local cost and utility data, and epidemiology data among Thai patients. Univariate and probabilistic sensitivity analyses were performed to account for parameter uncertainty.Results: Intravitreal bevacizumab (IVB) resulted in the lowest lifetime cost, followed by IVB plus verteporfin photodynamic therapy (IVB+vPDT) and intravitreal aflibercept (IVA). The combination of IVB or intravitreal ranibizumab (IVR) and verteporfin photodynamic therapy (IVB+vPDT or IVR+vPDT) yielded the highest quality-adjusted life-years (QALY). When compared with IVB from a societal perspective, the incremental cost-effectiveness ratio for patients with PCV receiving IVB+vPDT, IVR+vPDT, IVA were 10,304; 54,135; and 82,738 the United States dollar (USD) per QALY gained, respectively. At the Thai societal willingness to pay threshold of 4884 USD, IVB had the highest probability of being cost-effective (99%) followed by IVB+vPDT (1%). IVB+vPDT could be a cost-effective strategy and required a budget of 12.61 million USD over five fiscal years when the price of verteporfin reduced by approximately 45%.Conclusion: None of the drug treatments for PCV was cost-effective in the Thai context. The decreased price of verteporfin is required to support the inclusion of IVB+vPDT in the Thai National List of Essential Medicines for the treatment of PCV.Keywords: PCV, verteporfin, anti-VEGF agent, retinal disease, economic evaluation, Thailand
format	article
author	Sangroongruangsri S Chaikledkaew U Hanusaha P Ratanapakorn T Ruamviboonsuk P
author_facet	Sangroongruangsri S Chaikledkaew U Hanusaha P Ratanapakorn T Ruamviboonsuk P
author_sort	Sangroongruangsri S
title	Cost-Utility Analysis of Drug Treatments in Patients with Polypoidal Choroidal Vasculopathy in Thailand
title_short	Cost-Utility Analysis of Drug Treatments in Patients with Polypoidal Choroidal Vasculopathy in Thailand
title_full	Cost-Utility Analysis of Drug Treatments in Patients with Polypoidal Choroidal Vasculopathy in Thailand
title_fullStr	Cost-Utility Analysis of Drug Treatments in Patients with Polypoidal Choroidal Vasculopathy in Thailand
title_full_unstemmed	Cost-Utility Analysis of Drug Treatments in Patients with Polypoidal Choroidal Vasculopathy in Thailand
title_sort	cost-utility analysis of drug treatments in patients with polypoidal choroidal vasculopathy in thailand
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/67b022bcc6ad4fccbb614ba25aaf8fef
work_keys_str_mv	AT sangroongruangsris costutilityanalysisofdrugtreatmentsinpatientswithpolypoidalchoroidalvasculopathyinthailand AT chaikledkaewu costutilityanalysisofdrugtreatmentsinpatientswithpolypoidalchoroidalvasculopathyinthailand AT hanusahap costutilityanalysisofdrugtreatmentsinpatientswithpolypoidalchoroidalvasculopathyinthailand AT ratanapakornt costutilityanalysisofdrugtreatmentsinpatientswithpolypoidalchoroidalvasculopathyinthailand AT ruamviboonsukp costutilityanalysisofdrugtreatmentsinpatientswithpolypoidalchoroidalvasculopathyinthailand
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Cost-Utility Analysis of Drug Treatments in Patients with Polypoidal Choroidal Vasculopathy in Thailand

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