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Cost effectiveness of mirabegron compared with tolterodine extended release for the treatment of adults with overactive bladder in the United Kingdom.

Aballéa S, Maman K, Thokagevistk K, Nazir J, Odeyemi IA, Hakimi Z, Garnham A, Toumi M - Clin Drug Investig (2015)

Bottom Line: The resulting incremental cost-effectiveness ratio (ICER) was £4,386/QALY gained.The probability of mirabegron 50 mg being cost effective relative to tolterodine ER 4 mg was 89.4 % at the same WTP threshold.Mirabegron 50 mg/day is likely to be cost effective compared with tolterodine ER 4 mg/day for adult patients with OAB from a UK NHS perspective.

View Article: PubMed Central - PubMed

Affiliation: Creativ-Ceutical SARL, 215, rue du Faubourg St-Honoré, 75008, Paris, France, sab@creativ-ceutical.com.

ABSTRACT

Background: Overactive bladder (OAB) is highly prevalent and is associated with considerable morbidity and reduced health-related quality of life. β3-adrenergic receptor (β3-AR) stimulation is a novel alternative to antimuscarinic therapy for OAB.

Objective: The objective of this analysis was to assess the cost effectiveness of the β3-AR agonist mirabegron relative to tolterodine extended release (ER) in patients with OAB from a UK National Health Service (NHS) perspective.

Methods: A Markov model was developed to simulate the management, course of disease, and effect of complications in OAB patients over a period of 5 years. Transition probabilities for symptom severity levels and probabilities of adverse events were estimated from the results of the randomised, double-blind SCORPIO trial in 1,987 patients with OAB. Other model inputs were derived from the literature and on assumptions based on clinical experience.

Results: Total 5-year costs per patient were £1,645.62 for mirabegron 50 mg/day and £1,607.75 for tolterodine ER 4 mg/day. Mirabegron was associated with a gain of 0.009 quality-adjusted life-years (QALYs) with an additional cost of £37.88. The resulting incremental cost-effectiveness ratio (ICER) was £4,386/QALY gained. In deterministic sensitivity analyses in the general OAB population and several subgroups, ICERs remained below the generally accepted willingness-to-pay (WTP) threshold of £20,000/QALY gained. The probability of mirabegron 50 mg being cost effective relative to tolterodine ER 4 mg was 89.4 % at the same WTP threshold.

Conclusions: Mirabegron 50 mg/day is likely to be cost effective compared with tolterodine ER 4 mg/day for adult patients with OAB from a UK NHS perspective.

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Related in: MedlinePlus

Deterministic sensitivity analysis. AE adverse event, BTX botulinum toxin, EQ5D European Quality of Life questionnaire in five dimensions, ICER incremental cost-effectiveness ratio
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Related In: Results  -  Collection


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Fig2: Deterministic sensitivity analysis. AE adverse event, BTX botulinum toxin, EQ5D European Quality of Life questionnaire in five dimensions, ICER incremental cost-effectiveness ratio

Mentions: For the sensitivity analyses, health state utilities based on EQ-5D were used. Detailed results are shown in the tornado chart in Fig. 2. The model was most sensitive to the transition probabilities between symptom levels of incontinence and micturition for mirabegron and tolterodine, the distribution of patients by micturition and incontinence severity level at baseline, and the monthly probability of restarting treatment. However, mirabegron was cost effective or dominant compared with tolterodine in all scenarios. The ICER was also found to vary little (from £4,092 to 4,698/QALY gained) when the discount rate was varied from 0 to 6.0 % for costs and outcomes.Fig. 2


Cost effectiveness of mirabegron compared with tolterodine extended release for the treatment of adults with overactive bladder in the United Kingdom.

Aballéa S, Maman K, Thokagevistk K, Nazir J, Odeyemi IA, Hakimi Z, Garnham A, Toumi M - Clin Drug Investig (2015)

Deterministic sensitivity analysis. AE adverse event, BTX botulinum toxin, EQ5D European Quality of Life questionnaire in five dimensions, ICER incremental cost-effectiveness ratio
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4300413&req=5

Fig2: Deterministic sensitivity analysis. AE adverse event, BTX botulinum toxin, EQ5D European Quality of Life questionnaire in five dimensions, ICER incremental cost-effectiveness ratio
Mentions: For the sensitivity analyses, health state utilities based on EQ-5D were used. Detailed results are shown in the tornado chart in Fig. 2. The model was most sensitive to the transition probabilities between symptom levels of incontinence and micturition for mirabegron and tolterodine, the distribution of patients by micturition and incontinence severity level at baseline, and the monthly probability of restarting treatment. However, mirabegron was cost effective or dominant compared with tolterodine in all scenarios. The ICER was also found to vary little (from £4,092 to 4,698/QALY gained) when the discount rate was varied from 0 to 6.0 % for costs and outcomes.Fig. 2

Bottom Line: The resulting incremental cost-effectiveness ratio (ICER) was £4,386/QALY gained.The probability of mirabegron 50 mg being cost effective relative to tolterodine ER 4 mg was 89.4 % at the same WTP threshold.Mirabegron 50 mg/day is likely to be cost effective compared with tolterodine ER 4 mg/day for adult patients with OAB from a UK NHS perspective.

View Article: PubMed Central - PubMed

Affiliation: Creativ-Ceutical SARL, 215, rue du Faubourg St-Honoré, 75008, Paris, France, sab@creativ-ceutical.com.

ABSTRACT

Background: Overactive bladder (OAB) is highly prevalent and is associated with considerable morbidity and reduced health-related quality of life. β3-adrenergic receptor (β3-AR) stimulation is a novel alternative to antimuscarinic therapy for OAB.

Objective: The objective of this analysis was to assess the cost effectiveness of the β3-AR agonist mirabegron relative to tolterodine extended release (ER) in patients with OAB from a UK National Health Service (NHS) perspective.

Methods: A Markov model was developed to simulate the management, course of disease, and effect of complications in OAB patients over a period of 5 years. Transition probabilities for symptom severity levels and probabilities of adverse events were estimated from the results of the randomised, double-blind SCORPIO trial in 1,987 patients with OAB. Other model inputs were derived from the literature and on assumptions based on clinical experience.

Results: Total 5-year costs per patient were £1,645.62 for mirabegron 50 mg/day and £1,607.75 for tolterodine ER 4 mg/day. Mirabegron was associated with a gain of 0.009 quality-adjusted life-years (QALYs) with an additional cost of £37.88. The resulting incremental cost-effectiveness ratio (ICER) was £4,386/QALY gained. In deterministic sensitivity analyses in the general OAB population and several subgroups, ICERs remained below the generally accepted willingness-to-pay (WTP) threshold of £20,000/QALY gained. The probability of mirabegron 50 mg being cost effective relative to tolterodine ER 4 mg was 89.4 % at the same WTP threshold.

Conclusions: Mirabegron 50 mg/day is likely to be cost effective compared with tolterodine ER 4 mg/day for adult patients with OAB from a UK NHS perspective.

Show MeSH
Related in: MedlinePlus