Systematic review and cost-effectiveness of bosentan and sildenafil as therapeutic drugs for pediatric pulmonary arterial hypertension

被引:7
作者
Chen, Tingting [1 ]
Chen, Jiahe [2 ,3 ]
Chen, Chaoxin [1 ]
Zheng, Huanrui [1 ]
Chen, Yanhui [4 ]
Liu, Maobai [5 ]
Zheng, Bin [5 ]
机构
[1] Fujian Med Univ, Sch Pharm, Fuzhou, Peoples R China
[2] Univ Southern Calif, Sch Pharm, Dept Pharmaceut & Hlth Econ, Los Angeles, CA 90007 USA
[3] Univ Southern Calif, Leonard D Schaeffer Ctr Hlth Policy & Econ, Los Angeles, CA 90007 USA
[4] Fujian Med Univ, Dept Pediat, Union Hosp, Fuzhou, Peoples R China
[5] Fujian Med Univ, Dept Pharm, Union Hosp, 29 Xinquan Rd, Fuzhou 350001, Fujian, Peoples R China
关键词
bosentan; cost‐ effective analysis; Markov model; pediatric pulmonary arterial hypertension; sildenafil; CHILDREN; DISEASES; UTILITY; IMPACT;
D O I
10.1002/ppul.25427
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Background Pulmonary arterial hypertension (PAH) is a rare disease in children, with significant mortality. Because of the limited research on pediatric PAH, first, systematic review of related drugs is conducted, and then economic evaluation of PAH drug treatment programs is conducted, which to provide a reference for the choice of more cost-effective treatment options. Methods The search includes electronic databases such as Pubmed, ScienceDirect, and Embase. Through inclusion and exclusion criteria, screen high-quality randomized controlled trials. We used TreeAge Pro 2011 software to construct the markov model, that to simulate the total medical cost and quality-adjusted life years (QALYs), and to calculate the incremental cost-effectiveness ratio. Sensitivity analysis of transfer probability, utility, and cost was carried out. Results Incorporate two studies that meet the criteria, one compared the therapeutic effects of bosentan and placebo on pediatric PAH, the other compared therapeutic effects of sildenafil and placebo on pediatric PAH, both articles were of good quality. Compared with the sildenafil group (3.38QALYs and $161,120.14), the QALY of the bosentan treatment group (3.33QALYs and $257,411.29) was reduced by 0.05, and the cost increased by $96,291.15. The estimated improvement to quality of life and reduced costs result in an estimate of economic dominance for sildenafil over bosentan. This dominant result persisted probabilistic analyses. Conclusions Based on this model, a more cost-effective treatment drug for PAH in children is sildenafil.
引用
收藏
页码:2250 / 2258
页数:9
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