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."