Cost-effectiveness Analysis of Dupilumab for the Treatment of Adult Patients with Severe Prurigo Nodularis in Italy.

IF 3.7 4区 医学 Q1 DERMATOLOGY
Cataldo Patruno, Massimiliano Povero, Andrea Tassone, Maria Paola Pedone, Donia Bahloul, Jules Tavi, Paolo Amerio
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Abstract

Prurigo nodularis is characterized by intensely pruritic nodules that significantly impact patients' quality of life. This study aims to evaluate the cost-effectiveness of dupilumab compared with the best supportive care for the treatment of severe prurigo nodularis from the perspective of the Italian National Health Service. A cost-effectiveness model was developed using a decision tree followed by a Markov approach with a lifetime horizon (30 years). Baseline characteristics, efficacy, and utility data were derived from the pooled analysis of PRIME and PRIME2 trials. Direct healthcare costs based on drug acquisition, adverse event and complications management, and disease-related healthcare resource utilization were considered. Dupilumab improved health outcomes, with an incremental gain of 1.481 quality-adjusted life-years compared with best supportive care. The total cost of dupilumab treatment was €148,964, compared with €70,957 for the best supportive care arm, thus resulting in an incremental cost-effectiveness ratio of €52,661 per quality-adjusted life-year. Scenario analyses indicated that at a discount ≥ 20%, the incremental cost-effectiveness ratio was lower than €40,000/quality-adjusted life-year. Deterministic and probabilistic sensitivity analyses confirmed the robustness of the results. Dupilumab is likely to be a cost-effective treatment for severe prurigo nodularis patients eligible for systemic therapy in Italy, as it reduces disease burden and healthcare costs associated with uncontrolled prurigo nodularis.

意大利Dupilumab治疗成人严重结节性痒疹的成本-效果分析。
结节性痒疹的特点是强烈的瘙痒结节,显著影响患者的生活质量。本研究旨在从意大利国家卫生服务的角度评估dupilumab与最佳支持治疗相比治疗严重结节性痒疹的成本效益。利用决策树和马尔可夫方法建立了一个成本效益模型,该模型具有生命周期(30年)。基线特征、疗效和效用数据来源于PRIME和PRIME2试验的汇总分析。考虑了基于药物获取、不良事件和并发症管理以及疾病相关医疗资源利用的直接医疗成本。Dupilumab改善了健康结果,与最佳支持治疗相比,增加了1.481质量调整生命年。dupilumab治疗的总成本为148,964欧元,而最佳支持治疗组为70,957欧元,因此每个质量调整生命年的增量成本-效果比为52,661欧元。情景分析表明,折扣≥20%时,增量成本效益比低于40000欧元/质量调整生命年。确定性和概率敏感性分析证实了结果的稳健性。Dupilumab可能是一种具有成本效益的治疗方法,用于在意大利有资格接受全身治疗的严重结节性痒疹患者,因为它减少了与未控制的结节性痒疹相关的疾病负担和医疗费用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Acta dermato-venereologica
Acta dermato-venereologica 医学-皮肤病学
CiteScore
4.90
自引率
2.80%
发文量
210
审稿时长
6-12 weeks
期刊介绍: Acta Dermato-Venereologica publishes high-quality manuscripts in English in the field of Dermatology and Venereology, dealing with new observations on basic dermatological and venereological research, as well as clinical investigations. Each volume also features a number of Review articles in special areas, as well as short Letters to the Editor to stimulate debate and to disseminate important clinical observations. Acta Dermato-Venereologica has rapid publication times and is amply illustrated with a large number of colour photographs.
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