scholarly journals Cost-effectiveness of dutasteride-tamsulosin combination therapy for the treatment of symptomatic benign prostatic hyperplasia: A Canadian model based on the CombAT trial

2013 ◽  
Vol 7 (5-6) ◽  
pp. 393 ◽  
Author(s):  
Afisi Ismaila ◽  
Anna Walker ◽  
Amyn Sayani ◽  
Bruno Laroche ◽  
J. Curtis Nickel ◽  
...  
Keyword(s):  
Health Care ◽  
Cost Effectiveness ◽  
Benign Prostatic Hyperplasia ◽  
Combination Therapy ◽  
Patient Outcomes ◽  
Cost Effective ◽  
Prostatic Hyperplasia ◽  
Canadian Health Care System ◽  
Canadian Health ◽  
Canadian Health Care

Introduction: Benign prostatic hyperplasia (BPH) is common in men 50 years old and older. The main treatment options are alpha-blockers (such as tamsulosin), which reduce symptoms, and 5-alpha reductase inhibitors (such as dutasteride), which reduce symptoms and slow disease progression. Clinical studies have demonstrated that dutasteride-tamsulosin combination therapy is more effective than either monotherapy to treat symptomatic BPH. We studied the cost-effectiveness in Canada of the dutasteride (0.5 mg/day) and tamsulosin (0.4 mg/day) combination compared with tamsulosin or dutasteride monotherapy.Methods: A Markov model was developed which follows a cohort of male BPH patients ≥50 with moderate to severe lower urinary tract symptoms (LUTS). The model estimates costs to the Canadian health care system and outcomes (in terms of quality adjusted life years [QALYs]) at 10 years and over a patient’s lifetime. The dutasteride-tamsulosin combination was compared to each of tamsulosin monotherapy and dutasteride monotherapy.Results: Compared with tamsulosin, the combination was more costly and produced better patient outcomes. Over a lifetime, the incremental cost-effectiveness ratio was CAN$25 437 per QALY gained. At a willingness to pay CAN$50 000 per QALY, the probability of combination therapy being cost-effective was 99.6%. Compared with dutasteride, the combination therapy was the dominant option from year 2, offering improved patient outcomes at lower cost. The probability that combination therapy is more cost-effective than dutasteride was 99.8%.Conclusion: Combination therapy offers important clinical benefits for patients with symptomatic BPH, and there is a high probability that it is cost-effective in the Canadian health care system relative to either monotherapy.

The Effects of Misconceptions and Theoretical Beliefs on Data and Measurement Tools: A Reply

1993 ◽  
Vol 23 (2) ◽  
pp. 249-255 ◽  
Author(s):  
Ardeshir Sepehri ◽  
Robert Chernomas
Keyword(s):  
Health Care ◽  
Cost Effectiveness ◽  
Health Economics ◽  
Theoretical Approach ◽  
Health Expenditure ◽  
Relative Cost ◽  
Canadian Health Care System ◽  
Measurement Tools ◽  
Canadian Health ◽  
Canadian Health Care

The authors comment on Coyte's comparisons of health expenditure trends and provide some suggestions on how his two sets of contradictory results could be reconciled. The reconciliation of Coyte's results tends to support the claims made by the advocates of the Canadian health care system of its relative cost effectiveness. The authors conclude by providing a critique of Coyte's perspective of what properly constitutes a theoretical approach to health economics.

scholarly journals Cost effectiveness comparison of dutasteride and finasteride in patients with benign prostatic hyperplasia - the Markov model based on data from Montenegro

2016 ◽  
Vol 73 (1) ◽  
pp. 26-33 ◽  
Author(s):  
Vera Dabanovic ◽  
Marina Kostic ◽  
Slobodan Jankovic
Keyword(s):  
Health Care ◽  
Cost Effectiveness ◽  
Benign Prostatic Hyperplasia ◽  
Markov Model ◽  
Health Care Service ◽  
Cost Effective ◽  
Prostatic Hyperplasia ◽  
Common Disease ◽  
Life Years ◽  
Effective Option

Background/Aim. Benign prostatic hyperplasia (BPH) is one of the most common disease among males aging 50 years and more. The rise of the prevalence of BPH is related to aging, and since duration of life time period has the tendency of rising the prevalence of BPH will rise as costs of BPH treatment will and its influence on health economic budget. Dutasteride is a new drug similar to finasteride, inhibits enzyme testosterone 5-alpha reductase, diminish symptoms of BPH, reduce risk of the complications and increases quality of life in patients with BPH. But, the use of dutasteride is limited by its high costs. The aim of this study was to compare cost effectiveness of dutasteride and finasteride from the perspective of a purchaser of health care service (Republic Institute for Health Insuranse, Montenegro). ??thods. We constructed a Markov model to compare cost effectivenss of dutasteride and finasteride using data from the available pharmacoeconomic literature and data about socioeconomic sphere actual in Montenegro. A time horizon was estimated to be 20 years, with the duration of 1 year per one cycle. The discount rate was 3%. We performed Monte Carlo simulation for virtual cohort of 1,000 patients with BPH. Results. The total costs for one year treatment of BPH with dutasteride were estimated to be 6,458.00 ? which was higher comparing with finasteride which were 6,088.56 ?. The gain in quality adjusted life years (QALY) were higher with dutasteride (11.97 QALY ) than with finasteride (11.19 QALY). The results of our study indicate that treating BPH with dutasteride comparing to finasteride is a cost effective option since the value of incremental cost-effectiveness ratio (ICER) is 1,245.68 ?/QALY which is below estimated threshold (1,350.00 ? per one gained year of life). Conclusion. Dutasteride is a cost effective option for treating BPH comparing to finasteride. The results of this study provide new information for health care decision makers about treatment of BPH in socioeconomic environment which is actual both in Montenegro and other countries with a recent history of socioeconomic transition.

Cost-Effectiveness of Extended Thromboprophylaxis in Patients Undergoing Colorectal Surgery from a Canadian Health Care System Perspective

2019 ◽  
Vol 62 (11) ◽  
pp. 1381-1389 ◽  
Author(s):  
Maude Trepanier ◽  
Noura Alhassan ◽  
Christine A. Sabapathy ◽  
A. Sender Liberman ◽  
Patrick Charlebois ◽  
...  
Keyword(s):  
Health Care ◽  
Cost Effectiveness ◽  
Colorectal Surgery ◽  
Health Care System ◽  
System Perspective ◽  
Canadian Health Care System ◽  
Canadian Health ◽  
Canadian Health Care ◽  
Care System

scholarly journals Cost-effectiveness of TAS-102 plus bevacizumab versus TAS-102 monotherapy in patients with metastatic colorectal cancer

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kiyoaki Sugiura ◽  
Yuki Seo ◽  
Takayuki Takahashi ◽  
Hideyuki Tokura ◽  
Yasuhiro Ito ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Health Care ◽  
Sensitivity Analysis ◽  
Cost Effectiveness ◽  
Combination Therapy ◽  
Metastatic Colorectal Cancer ◽  
Cost Effective ◽  
Model Parameters ◽  
Combination Regimen ◽  
The Cost

Abstract Background TAS-102 plus bevacizumab is an anticipated combination regimen for patients who have metastatic colorectal cancer. However, evidence supporting its use for this indication is limited. We compared the cost-effectiveness of TAS-102 plus bevacizumab combination therapy with TAS-102 monotherapy for patients with chemorefractory metastatic colorectal cancer. Method Markov decision modeling using treatment costs, disease-free survival, and overall survival was performed to examine the cost-effectiveness of TAS-102 plus bevacizumab combination therapy and TAS-102 monotherapy. The Japanese health care payer’s perspective was adopted. The outcomes were modeled on the basis of published literature. The incremental cost-effectiveness ratio (ICER) between the two treatment regimens was the primary outcome. Sensitivity analysis was performed and the effect of uncertainty on the model parameters were investigated. Results TAS-102 plus bevacizumab had an ICER of $21,534 per quality-adjusted life-year (QALY) gained compared with TAS-102 monotherapy. Sensitivity analysis demonstrated that TAS-102 monotherapy was more cost-effective than TAS-102 and bevacizumab combination therapy at a willingness-to-pay of under $50,000 per QALY gained. Conclusions TAS-102 and bevacizumab combination therapy is a cost-effective option for patients who have metastatic colorectal cancer in the Japanese health care system.

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