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News

Cost of treatment of primary biliary cirrhosis with ursodeoxycholic acid

This month's Alimentary Pharmacology & Therapeutics investigates the cost and health consequences of treatment of primary biliary cirrhosis with ursodeoxycholic acid.

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Long-term use of ursodeoxycholic acid is the recommended therapy in primary biliary cirrhosis.

The lifetime effectiveness and cost-effectiveness of ursodeoxycholic acid in primary biliary cirrhosis have, however, not been assessed.

Dr Boberg and colleagues from Norway estimated the health outcomes and lifetime costs of a Norwegian cohort of primary biliary cirrhosis patients on ursodeoxycholic acid.

Norwegian primary biliary cirrhosis patients who were included in a 5-year open-label study of ursodeoxycholic acid therapy were subsequently followed up for up to 12 years.

The lifetime survival was estimated using a Weibull survival model.

There was a 82% probability that ursodeoxycholic acid entails greater life expectancy
Alimentary Pharmacology & Therapeutics

The survival benefit from ursodeoxycholic acid was based on a randomized clinical trial from Canada, comparing the effect of non-ursodeoxycholic acid and ursodeoxycholic acid.

Survival and costs of standard care vs. standard care plus ursodeoxycholic acid were simulated in a Markov model with death and liver transplantation as major events, invoking transition of a patient's state in the model.

The team analyzed the gain in life expectancy for a primary biliary cirrhosis patient on ursodeoxycholic acid compared with standard care was about 2 years.

The researchers found that lifetime treatment costs were EUR 151,403 and EUR 157,741 for patients with and without ursodeoxycholic acid, respectively.

A probabilistic sensitivity analysis indicated an 82% probability that ursodeoxycholic acid entails both greater life expectancy and lower costs than standard care.

Dr Boberg's team concludes, "The results of this study indicate that ursodeoxycholic acid therapy is a dominant strategy as it confers reduced morbidity and mortality, as well as cost savings, compared with standard therapy."

Aliment Pharmacol Ther 2013: DOI: 10.1111/apt.12435
21 August 2013

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