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Báo cáo y học: " Cost-utility of Intravenous Immunoglobulin (IVIG) compared with corticosteroids for the treatment of Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) in Canada"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Cost-utility of Intravenous Immunoglobulin (IVIG) compared with corticosteroids for the treatment of Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) in Canada. | Blackhouse et al. Cost Effectiveness and Resource Allocation 2010 8 14 http www.resource-allocation.eom content 8 1 14 COST EFFECTIVENESS AND RESOURCE ALLOCATION RESEARCH Open Access Cost-utility of Intravenous Immunoglobulin IVIG compared with corticosteroids for the treatment of Chronic Inflammatory Demyelinating Polyneuropathy CIDP in Canada Gord Blackhouse 1 2 Kathryn Gaebel1 3 Feng Xie1 2 3 Kaitryn Campbell1 2 Nazila Assasi1 2 Jean-Eric Tarride1 2 3 Daria O Reilly1 2 3 Colin Chalk4 Mitchell Levine2 3 and Ron Goeree1 2 3 Abstract Objectives Intravenous immunoglobulin IVIG has demonstrated improvement in chronic inflammatory demyelinating polyneuropathy CIDP patients in placebo controlled trials. However IVIG is also much more expensive than alternative treatments such as corticosteroids. The objective of the paper is to evaluate from a Canadian perspective the cost-effectiveness of IVIG compared to corticosteroid treatment of CIDP Methods A markov model was used to evaluate the costs and QALYs for IVIG and corticosteroids over 5 years of treatment for CIDP Patients initially responding to IVIG could remain a responder or relapse every 12 week model cycle. Non-responding IVIG patients were assumed to be switched to corticosteroids. Patients on corticosteroids were at risk of a number of adverse events fracture diabetes glaucoma cataract serious infection in each cycle. Results Over the 5 year time horizon the model estimated the incremental costs and QALYs of IVIG treatment compared to corticosteroid treatment to be 124 065 and 0.177 respectively. The incremental cost per QALY gained of IVIG was estimated to be 687 287. The cost per QALY of IVIG was sensitive to the assumptions regarding frequency and dosing of maintenance IVIG. Conclusions Based on common willingness to pay thresholds IVIG would not be perceived as a cost effective treatment for CIDP Introduction Chronic inflammatory demyelinating polyneuropathy CIDP is an acquired immune-mediated inflammatory