Cost-effectiveness of the anti-fibrotics for the treatment of idiopathic pulmonary fibrosis in the United States

BMC Pulmonary Medicine

Timothy M. Dempsey¹  James P. Moriarty²  Viengneesee Thao²  Bijan J. Borah²  Andrew H. Limper² 

[1] David Grant Medical Center, US Air Force;Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic;

关键词: Idiopathic pulmonary fibrosis;    Cost-effectiveness analysis;    Pirfenidone;    Nintedanib;   

DOI  :  10.1186/s12890-021-01811-0

来源: DOAJ

【 摘 要 】

Abstract Background The anti-fibrotic medications nintedanib and pirfenidone were approved in the United States for use in patients with idiopathic pulmonary fibrosis several years ago. While there is a growing body of evidence surrounding their clinical effectiveness, these medications are quite expensive and no prior cost-effectiveness analysis has been performed in the United States. Methods A previously published Markov model performed in the United Kingdom was replicated using United States data to project the lifetime costs and health benefits of treating idiopathic pulmonary fibrosis with: (1) symptom management; (2) pirfenidone; or (3) nintedanib. For the cost-effectiveness analysis, strategies were ranked by increasing costs and then checked for dominating treatment strategies. Then an incremental cost-effectiveness ratio was calculated for the dominant therapy. Results The anti-fibrotic medications were found to cost more than $110,000 per year compared to $12,291 annually for symptom management. While pirfenidone was slightly more expensive than nintedanib and provided the same amount of benefit, neither medication was found to be cost-effective in this U.S.-based analysis, with an average cost of $1.6 million to gain one additional quality-adjusted life year over symptom management. Conclusions Though the anti-fibrotics remain the only effective treatment option for patients with idiopathic pulmonary fibrosis and the data surrounding their clinical effectiveness continues to grow, they are not considered cost-effective treatment strategies in the United States due to their high price.

【 授权许可】

Unknown