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Posicionamiento de pegfilgrastim en las tablas clasificatorias de España según coste por años de vida ajustados por calidad (AVAC) y coste por años de vida ganados (AVG)

  • Josep Darbà
  • G. Restovic
  • R. Arocho
Artículo Original
  • 9 Downloads

Resumen

Objetivos. El objetivo principal es posicionar los resultados obtenidos de un estudio económico de pegfilgrastim en las tablas clasificatorias de coste-efectividad de intervenciones sanitarias publicadas en España durante el período 1997–2006.

Métodos. Para elaborar las tablas clasificatorias se llevó a cabo una revisión bibliográfica en tres importantes bases de datos. El periodo de búsqueda fue desde 1997 hasta 2006. Con el empleo de los criterios de selección establecidos se localizaron 29 publicaciones con 42 observaciones de razones coste-efectividad incremental (RCEI) por AVAC ganados y 24 publicaciones con 42 observaciones de RCEI por AVG ganados. Los resultados se actualizaron a valores del año 2006.

Resultados. Excluyendo los valores extremos de las 42 observaciones para AVAC, se tienen 37 observaciones con una media de 12.295 € por AVAC ganado (IC del 95%: 7.534 €; 17.056 €). Considerando las 42 observaciones para AVG la media por RCEI fue de 22.339 € (IC del 95%: 8.703 €-35.975 €). Los resultados de la RCEI por AVAC ganado con pegfilgrastim fueron: (1) frente a filgrastim administrado durante 11 días: pegfilgrastim opción dominante y (2) frente a filgrastim administrado durante 6 días: 13.933 €. Los resultados de la RCEI por AVG con pegfilgrastim fueron: (1) frente a filgrastim administrado durante 11 días: pegfilgrastim opción dominante y (2) frente a filgrastim administrado durante 6 días: 13.180 €.

Conclusiones. Los resultados del análisis de evaluación económica de pegfilgrastim frente a filgrastim, medidos tanto en AVG como en AVAC, se encuentran dentro de los rangos de las razones de coste-efectividad incrementales obtenidas en la revisión de la literatura para España durante el período 1997–2006.

Palabras clave

Tablas clasificatorias AVAC AVG RCEI pegfilgrastim 

Abstract

Objectives. The main objective was to compare pegfilgratism cost-effectiveness results with those in the league tables developed for Spain based on economic evaluations published in Spain during 1997 to 2006.

Methods. A structured literature review was conducted in PubMed (National Library of Medicine), DOYMA Editions and the economic evaluation database developed by the Centre for Reviews and Disseminations (CRD-University of York). Time period covered in the review was from 1997 to 2007. Twenty nine abstracts and papers met the inclusion criteria with its corresponding 42 outputs reporting on ICER per QALY gained and 42 outputs reporting on ICER per LYG. Reported economic outcomes were converted to 2006 using consumer price index.

Results. From literature review, the mean ICER per QALY gained was estimated at 185,201 € (CI 95%: 615 €-369,786 €). While the mean ICER per LYG was estimated at 22,339 € (CI 95%: 8,703 €-35,975 €). The economic model estimated pegfilgrastim to be the dominant option over filgrastim (administered for 11 days) regardless whether the ICER per QALY or per LYG was used as the metric. While the ICER per QALY gained of pegfilgrastim as compared to filgrastim (administered for 6 days) was 13,933€ (13,180€ per LYG).

Conclusions. The results of the economic analysis of pegfilgratim frente a Filgrastim measured in LYG and QALYs, are within the range of ICER obtained in the literature review conducted for Spain during the period 1997–2006.

Key words

Leagues tables QALY LYG ICER pegfilgrastim 

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Bibliografía

  1. 52.
    Pinto JL Sánchez F. Métodos para la evaluación económica de nuevas prestaciones. Editado por: Centre de Recerca en Economia i Salut 3- Cres y Ministeria de Sanidad y Consumo, España. Disponible en URL: http://www.msc.es
  2. 53.
    George B Harris A Mitchell A. Cost-effectiveness analysis and the consistency of decision making: evidence from pharmaceutical reimbursement in Australia (1991 to 1996). Pharmacoeconomics. 2001;19(11):1103–9PubMedCrossRefGoogle Scholar
  3. 54.
    Sacristán, Oliva J, Del Llano J, Prieto L, Pinto L. ¿Qué es una tecnología sanitaria eficiente en España?. Gac Sanit 2002;16(4):334–43Google Scholar
  4. 55.
    Mayordomo J, Lopez Pousa A, Arocho R, Doan Qv, Dubois RW, Liu Z. Primary Prophylaxis with pegfilgrastim is Costsaving Compared with filgrastim for Breast Cancer in Spain. Comunicación presentada al congreso Europeo de la International Society For Pharmacoeconomics and Outcomes Research (ISPOR), 282–31 Octubre 2006, Copenhagen, Dublin. Disponible en: http://www3.interscience.wiley.com/journal/118590031/abstract?CRETRY=1&SRETRY=0 Google Scholar
  5. 56.
    Darbà J, Restovic G, Mayordomo J, López Pousa A, Doan QV, Dubois RW, Liu Z, Arocho R. Cost-effectiveness (CE) of Febrile Neutropenia (FN) Primary Prophylaxis With Pegfilgrastim or Filgrastim in the Medical Treatment of Breast Cancer (BC) in Spain. Comunicación presentada al congreso de la Health Technology Assessment International (HTAi), en 172–20 Junio 2007, Barcelona, EspañaGoogle Scholar
  6. 57.
    Darbà J, Restovic G, Mayordomo J, López Pousa A, Doan QV, Dubois RW, Liu Z, Arocho R. Estudio de coste-efectividad de pegfilgrastim versus filgrastim administrado según la práctica habitual (6 inyecciones por ciclo) en la profilaxis primaria del cáncer de mama en España. Comunicación presentada a las XXVII Jornadas de la Asociación de Economía de la Salud (AES), 62–9 Junio 2007, A Coruña, España. Disponible en: http://www.aes.es/Jornadas2007/comunicaciones_aceptadas.php Google Scholar
  7. 58.
    Guide to the Methods of Technology Appraisal, Published by the National Institute for Clinical Excellence Printed by Abba Litho Sales Limited, London April 2004Google Scholar
  8. 59.
    Orlewska E Mierzejewski P. Proposal of Polish Guidelines for conducting financial analysis and their comparison to exiting guidance on budget impact in other countries. Value in Health 2004;7(1):1–10PubMedCrossRefGoogle Scholar
  9. 60.
    Canadian Coordinating Office for Health Technology Assesment. Guidelines for economic evaluation of pharmaceuticals: Canada 2nd ed. Ottawa: Canadian Coordinating Office for Health Technology Assessment (CCOHTA);1997Google Scholar
  10. 61.
    Australia Commonwealth Deparment of Health Housing, Community Services. Guidelines for the Pharmaceutical Industry on Preparation of Submission to the Pharmaceutical Benefits Advisory Commitee. Canberra: Government Publication, 1992Google Scholar
  11. 62.
    De Cock E Miratvitlles M Gonzalez-Juanatey JR. Valor umbral del coste por año de vida ganado para recomendar la adopción de tecnologías sanitarias en España: evidencias procedentes de una revisión de la literatura. Pharmacoeconomics Span Res Art 2007; 4: 97–107Google Scholar
  12. 63.
    Annemans L Lamotte M Kubin M Evers T Verheugt FW. Which patients should receive aspirin for primary prevention of cardiovascular disease? An economic evaluation. Int J Clin Pract 2006; 60(9):1129–37PubMedCrossRefGoogle Scholar
  13. 64.
    Borgstrom F Carlsson A Sintonen H Boonen S Haentjens P Burge R Johnell O Jonsson B Kanis JA. The cost-effectiveness of risedronate in the treatment of osteoporosis: an international perspective. Osteoporos Int. 2006;17(7):996–1007PubMedCrossRefGoogle Scholar
  14. 65.
    Fernandez de Bobadilla J Lopez de Sa E Alonso I Moreno R Rubio-Terres C Soto J. Cost-effectiveness analysis of the use of atorvastatin in patients with type 2 diabetes mellitus: a pharmacoeconomic model of the CARDS study. An Med Interna. 2006 May;23(5):213–9PubMedGoogle Scholar
  15. 66.
    Gil JM Rubio-Terres C Del Castillo A Gonzalez P Canorea F. Pharmacoeconomic analysis of adjuvant therapy with exemestane, anastrozole, letrozole or tamoxifen in postmenopausal women with operable and estrogen receptor-positive breast cancer. Clin Transl Oncol 2006;8(5):339–48PubMedCrossRefGoogle Scholar
  16. 67.
    Gomez-Outes A Rocha E Martinez-Gonzalez J Kakkar VV. Cost effectiveness of bemiparin sodium versus unfractionated heparin and oral anticoagulants in the acute and long-term treatment of deep vein thrombosis. Pharmacoeconomics. 2006;24(1):81–92CrossRefGoogle Scholar
  17. 68.
    Lamotte M Piñol C Brotons C Annemans L Guardiola E Evers T Kubin M. Evaluación económica del tratamiento con ácido acetilsalicílico en dosis bajas en la prevención primaria de enfermedades cardiovasculares. Rev Esp Cardiol. 2006;59:807–15PubMedCrossRefGoogle Scholar
  18. 69.
    Lazaro Y de Mercado P Figueras J Domenech E Echaniz I Closa R Wood MA Fitch K. The efficiency (cost-effectiveness) of palivizumab as prophylaxis against respiratory syncytial virus infection in premature infants with a gestational age of 322–35 weeks in Spain. An Pediatr (Barc). 2006;65(4):316–24CrossRefGoogle Scholar
  19. 70.
    Mar J Gutiérrez-Moreno S Chilcott J. Análisis coste-efectividad de tipo probabilístico del tratamiento de la apnea del sueño. Gac Sanit 2006;20:47–53PubMedCrossRefGoogle Scholar
  20. 71.
    San Miguel R Mar J Cabases JM Guillen-Grima F Buti M. Cost-effectiveness analysis of therapeutic strategies for patients with chronic hepatitis C previously not responding to interferon. Aliment Pharmacol Ther 2003;17(6):765–73PubMedCrossRefGoogle Scholar
  21. 72.
    Shearer AT Bagust A Ampudia FJ Martinez-Lage B Perez I Paris G. Lifetime health consequences and cost-effectiveness of rosiglitazone in combination with metformin for the treatment of type 2 diabetes in Spain. Pharmacoeconomics. 2006;24 Suppl 1:49–59PubMedGoogle Scholar
  22. 73.
    Croom KF Plosker GL. Eplerenone: a pharmacoeconomic review of its use in patients with post-myocardial infarction heart failure. Pharmacoeconomics. 2005;23(10):1057–72PubMedCrossRefGoogle Scholar
  23. 74.
    Grau S Alvarez-Lerma F del Castillo A Neipp R Rubio-Terres C. Cost-effectiveness analysis of the treatment of ventilatorassociated pneumonia with linezolid or vancomycin in Spain. J Chemother 2005;17(2):203–11PubMedGoogle Scholar
  24. 75.
    Rubio-Terres C Dominguez A. Cost-utility analysis of relapsing- remitting multiple sclerosis treatment with azathioprine or interferon beta in Spain. Rev Neurol 2005;40(12):705–10PubMedGoogle Scholar
  25. 76.
    Medina-Redondo F Herrera-Carranza J Sanabria C Navarro G Garcia-Moreno JM Gamero-Garcia MA Paramo MD Ruiz-Pena JL Izquierdo G. The efficiency and cost-utility ratio of interferon beta in the treatment of multiple sclerosis in Andalusia. Rev Neurol. 2004;39(1):1–6PubMedGoogle Scholar
  26. 77.
    Latour-Perez J Navarro-Ruiz A Ridao-Lopez M Cervera-Montes M. Using clopidogrel in non-ST-segment elevation acute coronary syndrome patients: a cost-utility analysis in Spain. Value Health. 2004 Jan–Feb;7(1):52–60PubMedCrossRefGoogle Scholar
  27. 78.
    López J Prieto M de San Luis LC Pascual R Treceño J. Análisis coste-efectividad en procesos que requieren ventilación mecánica. Estudio de los GRD 475 y 483. Med Intensiva. 2004; 28:349–55Google Scholar
  28. 79.
    Lyseng-Williamson KA, Plosker GL. Etanercept: a pharmacoeconomic review of its use in rheumatoid arthritis. Pharmacoeconomics. 2004; 22(16):1071–95PubMedCrossRefGoogle Scholar
  29. 80.
    Buti M Medina M Casado MA Wong JB Fosbrook L Esteban R. A cost-effectiveness analysis of peginterferon alfa-2b plus ribavirin for the treatment of naive patients with chronic hepatitis C. Aliment Pharmacol Ther 2003;17(5):687–94PubMedCrossRefGoogle Scholar
  30. 81.
    Rubio-Terres C Aristegui Ruiz I Medina Redondo F Izquierdo Ayuso G. Cost-utility analisys of multiple sclerosis treatment with glatiramer acetate or interferon beta in Spain. Farm Hosp 2003; 27(3): 159–65PubMedGoogle Scholar
  31. 82.
    Hart WM Rubio-Terrés C Burrell A Aristegui I Escobar-Jiménez F. Análisis farmacoeconómico del tratamiento de la osteoporosis postmenopáusica con risedronato o alendronato. Rev Esp Enferm Metab Oseas. 2002;11:97–104Google Scholar
  32. 83.
    Rodríguez Roldan JM Alonso P López J Del Nogal F Jiménez MJ Suárez J. Análisis de coste-efectividad de la ventilación mecánica y del tratamiento intensivo de pacientes en situación crítica. Med Intensiva 2002;26:391–8Google Scholar
  33. 84.
    Mar J Rodriguez-Artalejo F. Which is more important for the efficiency of hypertension treatment: hypertension stage, type of drug or therapeutic compliance? J Hypertens 2001;19(1):149–55PubMedCrossRefGoogle Scholar
  34. 85.
    Pereira A Sanz C. A model of the health and economic impact of post-transfusion hepatitis C: application to cost-effectiveness analysis of further expansion of HCV screening protocols. Transfusion 2001;41(6):832–39PubMedCrossRefGoogle Scholar
  35. 86.
    Ament A Baltussen R Duru G Rigaud-Bully C de Graeve D Ortqvist A Jonsson B Verhaegen J Gaillat J Christie P Cifre A S Vivas D Loiseau C Fedson D S. Cost-effectiveness of pneumococcal vaccination of older people: a study in 5 western European countries. Clinical Infectious Diseases 2000;31(2):444–50PubMedCrossRefGoogle Scholar
  36. 87.
    Buti M Casado M A Fosbrook L Wong J B Esteban R. Costeffectiveness of combination therapy for naive patients with chronic hepatitis C. J of Hepatology 2000;33(4):651–58CrossRefGoogle Scholar
  37. 88.
    Lopez J Nieto M Rodriguez C Molinero J Olmo G Albero J S. Economic evaluation of colorectal cancer screening with faecal occult blood detection. Rev Española de Enfermedades Digestivas 2000;92(5):342–348Google Scholar
  38. 89.
    Pereira A Sanz C. A model of the health and economic impact of posttransfusion hepatitis C: application to cost-effectiveness analysis of further expansion of HCV screening protocols. Transfusion 2000;40(10):1182–91PubMedCrossRefGoogle Scholar
  39. 90.
    Añon JM Garcia de Lorenzo A Zarazaga A Gomez-Tello V Garrido G. Mechanical ventilation of patients on long-term oxygen therapy with acute exacerbations of chronic obstructive pulmonary disease: prognosis and cost-utility analysis. Intensive Care Med 1999;25(5):452–7PubMedCrossRefGoogle Scholar
  40. 91.
    Pereira A. Cost-effectiveness of transfusing virus-inactivated plasma instead of standard plasma. Transfusion 1999;39(5):479–87CrossRefGoogle Scholar
  41. 92.
    Lyseng-Williamson KA, Plosker GL. Clopidogrel: a pharmacoeconomic review of its use in patients with non-ST elevation acute coronary syndromes. Pharmacoeconomics 2006;24(7):709–26PubMedCrossRefGoogle Scholar
  42. 93.
    Badia X Bueno HGonzález J Valentín V Rubio M. Análisis de la relación coste-efectividad a corto y largo plazo de clopidogrel añadido a terapia estándar en pacientes con síndrome coronario agudo en España. Rev Esp Cardiol 2005;58:1385–95PubMedCrossRefGoogle Scholar
  43. 94.
    Asensi F De Jose M Lorente M Moraga F Ciuryla V Arikian S Casciano R Vento M. A pharmacoeconomic evaluation of seven-valent pneumococcal conjugate vaccine in Spain. Value Health. 2004 Jan–Feb;7(1):36–51PubMedCrossRefGoogle Scholar
  44. 95.
    Cook J Alemao E Davies G Krobot K J Veltri E Lipka L Badia X. Cost-effectiveness of ezetimibe coadministration in statintreated patients not at cholesterol goal: application to Germany, Spain and Norway 2004. Pharmacoeconomics 2004;22(3): 49–61PubMedGoogle Scholar
  45. 96.
    Sacristán J Prieto L Huete T Artigas A Badia X Chinn C Hudson P. Coste-efectividad de drotrecogina alfa (activada) en el tratamiento de la sepsis grave en España. Gac Sanit. 2004;18:50–7.PubMedCrossRefGoogle Scholar
  46. 97.
    Antoñanzas F Portillo F. Evaluación económica del empleo de terapias farmacológicas para la cesación en el hábito tabáquico. Gac Sanit. 2003;17:393–403PubMedCrossRefGoogle Scholar
  47. 98.
    Moreno A Vargas E Soto J Rejas J. Análisis coste-efectividad del empleo de celecoxib en el tratamiento de la artrosis. Gac Sanit 2003; 17:27–36PubMedCrossRefGoogle Scholar
  48. 99.
    San Miguel R Mar J Cabases JM Guillen-Grima F Buti M. Cost-effectiveness analysis of therapeutic strategies for patients with chronic hepatitis C previously not responding to interferon. Aliment Pharmacol Ther 2003;17(6):765–73.PubMedCrossRefGoogle Scholar
  49. 100.
    Hart WM Rubio-Terres C Pajuelo F Juanatey JR. Cost-effectiveness of the treatment of heart failure with ramipril: a Spanish analysis of the AIRE study 2002. European Journal of Heart Failure 2002;4(4):553–8PubMedCrossRefGoogle Scholar
  50. 101.
    Lindgren P Jonsson B Redaelli A Radice D. Cost-effectiveness analysis of exemestane compared with megestrol in advanced breast cancer: a model for Europe and Australia 2002. Pharmacoeconomics 2002;20(2):101–8PubMedCrossRefGoogle Scholar
  51. 102.
    Plans P. Coste-efectividad de la vacunación antineumocócica 23-valente en Cataluña. Gac Sanit. 2002;16:392–400PubMedGoogle Scholar
  52. 103.
    Plans P Tresserras R Navas E Pardell H. Cost-effectiveness of hypertension treatment in Catalonia (Spain). Med Clin (Barc) 2002;118(6):211–6Google Scholar
  53. 104.
    Antoñanzas F Antón F. Evaluación económica de eptifibatide. Rev Esp Cardiol 2001;54:169–174Google Scholar
  54. 105.
    Young M Plosker GL. Paclitaxel: a pharmacoeconomic review of its use in the treatment of ovarian cancer. Pharmacoeconomics 2001;19(12):1227–59PubMedCrossRefGoogle Scholar
  55. 106.
    Gonzalez-Larriba JL Serrano S Alvarez M Camacho F Casado MA Díaz JL Díaz E Fosbrook L Guillem V Lopez JJ Moreno A Toribio J. Cost-effectiveness analysis of interferon as adjuvant therapy in high-risk melanoma patients in Spain. Eur. J. Cáncer 2000 Dec;36 (18):2344–52PubMedCrossRefGoogle Scholar
  56. 107.
    Ferriols R Ferriols F Evaluación farmacoeconómica de la asociación del ácido folínico y el 5-fluorouracilo en el tratamiento del carcinoma colorrectal avanzado. Farm Hosp 1998;23 (5):232–240Google Scholar
  57. 108.
    Plans-Rubio P. Cost-effectiveness of cardiovascular prevention programs in Spain. Int J Technol Assess Health Care1998;14(2):320–30PubMedCrossRefGoogle Scholar

Copyright information

© Adis Data Information BV 2008

Authors and Affiliations

  • Josep Darbà
    • 1
  • G. Restovic
    • 2
  • R. Arocho
    • 3
  1. 1.Departamento de Teoría EconómicaUniversitat de BarcelonaBarcelonaEspaña
  2. 2.BCN Health Economics & Outcomes ResearchEspaña
  3. 3.Amgen SAEspaña

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