Share This Article:

Cost-Effectiveness of Somatostatin Analogues for the Treatment of Acromegaly in Colombia

Abstract Full-Text HTML Download Download as PDF (Size:323KB) PP. 102-106
DOI: 10.4236/ojemd.2012.24016    4,299 Downloads   7,858 Views   Citations

ABSTRACT

Background: Somatostatin analogues have shown to be effective in controlling the levels of growth hormone and are recommended for the treatment of acromegaly. These treatments have high costs of acquisition and their use might be restricted in limited resource settings. Objective: To evaluate the cost-effectiveness of somatostatin analogues for acromegaly in Colombia. Setting/Subjects/Intervention: A decision model was developed using a hypothetical cohort of patients with Acromegaly. Patients were treated according to the clinical practice of the country. Response to treatment and transition probabilities were derived from published literature. Costs and resource utilization were extracted from public and private sources in Colombia. Main Outcome Measure(s): Cost-effectiveness ratio, measured in Colombian pesos in a 2 year time-horizon. Results: The total medical treatment costs for the octreotide group were (Colombian Pesos) COP$ 53,807,616, compared to the total costs for the lanreotide group of COP$ 83,126,567. In the octreotide arm 65.30% of the patients and in the lanreotide arm 59.50% of the patients were successfully controlled. The number of deaths was 295 (13.1%) and 302 (13.4%) for octreotide and lanreotide, respectively. Because the costs are lower and the effectiveness is higher for octreotide in comparison with lanreotide, octreotide is more cost-effective than lanreotide. Probabilistic sensitivity analyses were consistent showing octreotide as the most cost-effective option. Conclusions: Costs and effects of octreotide compare favorably to those of lanreotide in the treatment of acromegaly in Colombia. Sensitivity analysis showed that despite the uncertainty in cost-effectiveness ratio this result is robust.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

R. Alfonso-Cristancho, S. Herran Diazgranados, K. Maestre Martinez and O. David Diaz-Sotelo, "Cost-Effectiveness of Somatostatin Analogues for the Treatment of Acromegaly in Colombia," Open Journal of Endocrine and Metabolic Diseases, Vol. 2 No. 4, 2012, pp. 102-106. doi: 10.4236/ojemd.2012.24016.

References

[1] S. Melmed, “Acromegaly Pathogenesis and Treatment,” 2009. http://www.ncbi.nlm.nih.gov/pubmed/19884662
[2] S. Melmed, “Medical Progress: Acromegaly,” 2006. http://www.ncbi.nlm.nih.gov/pubmed/17167139
[3] B. A. Bengtsson, S. Eden, I. Ernest, A. Odén and B. Sj?gren, “Epidemiology and Long-Term Survival in Acromegaly: A Study of 166 Cases Diagnosed between 1955 and 1984,” 1988. http://www.ncbi.nlm.nih.gov/pubmed/3369313
[4] S. Melmed, A. Colao, A. Barkan, M. Molitch, A. B. Grossman and D. Kleinberg, “Guidelines for Acromegaly Management: An Update,” 2009. http://www.ncbi.nlm.nih.gov/pubmed/19208732
[5] A. Colao, D. Ferone, P. Marzullo and G. Lombardi, “Systemic Complications of Acromegaly: Epidemiology, Pathogenesis, and Management,” 2004. http://www.ncbi.nlm.nih.gov/pubmed/14769829
[6] O. Dekkers, N. Biermasz, A. Pereira, J. Romijn, J. Vandenbroucke, “Mortality in acromegaly: A metaanalysis,” 2008. http://www.ncbi.nlm.nih.gov/pubmed/17971431
[7] A. Barkan, M. D. Bronstein, O. D. Bruno, A. Cob, A. L. Espinosa de los Monteros and M. R. Gadelha, “Management of Acromegaly in Latin America: Expert Panel Recommendations,” 2010. http://www.ncbi.nlm.nih.gov/pubmed?term=Management%20of%20acromegaly%20in%20latin%20america%3A%20Expert%20panel%20recommendations
[8] E. R. Laws, “Surgery for Acromegaly: Evolution of the Techniques and Outcomes,” 2008. http://www.ncbi.nlm.nih.gov/pubmed/18228147
[9] R. Cozzi, M. Montini, R. Attanasio, M. Albizzi, G. Lasio and S. Lodrini, “Primary Treatment of Acromegaly with Octreotide LAR: A Long-Term (up to Nine Years) Prospective Study of Its Efficacy in the Control of Disease Activity and Tumor Shrinkage,” 2006. http://www.ncbi.nlm.nih.gov/pubmed/16449332
[10] R. D. Murray and S. Melmed, “A Critical Analysis of Clinically Available Somatostatin Analog Formulations for Therapy of Acromegaly,” 2008. http://www.ncbi.nlm.nih.gov/pubmed/18477663 doi:10.1210/jc.2008-0027
[11] U. P. Freda, C. M. Reyes, A. T. Nuruzzaman, R. E. Sundeen, A. G. Khandji and K. D. Post, “Cabergoline Therapy of Growth Hormone & Growth Hormone/Prolactin Secreting Pituitary Tumors,” 2004. http://www.ncbi.nlm.nih.gov/pubmed/15638294
[12] P. J. Jenkins, P. Bates, M. N. Carson, P. M. Stewart and J. A. Wass, “Conventional Pituitary Irradiation Is Effective in Lowering Serum Growth Hormone and Insulin-Like Growth Factor-I in Patients with Acromegaly,” 2006. http://www.ncbi.nlm.nih.gov/pubmed/16403824
[13] R. D. Murray and S. Melmed, “A Critical Analysis of Clinically Available Somatostatin Analog Formulations for Therapy of Acromegaly,” 2008. http://www.ncbi.nlm.nih.gov/pubmed/18477663 doi:10.1210/jc.2008-0027
[14] R. Cozzi, R. Attanasio, S. Lodrini and G. Lasio, “Cabergoline Addition to Depot Somatostatin Analogues in Resistant Acromegalic Patients: Efficacy and Lack of Predictive Value of Prolactin Status,” 2004. http://www.ncbi.nlm.nih.gov/pubmed/15272916
[15] Tabla Anual de Mortalidad, “DANE—Departamento Dministrative Nacional de Estadistica,” 2010. http://www.dane.gov.co/daneweb_V09/
[16] J. Valentim, V. Passos, F. Mataveli and A. Calabró, “Cost-Effectiveness Analysis of Somatostatin Analogues in the Treatment of Acromegaly in Brazil” 2008. http://www.ncbi.nlm.nih.gov/pubmed/19197453
[17] P. Chanson, “Predicting the Effects of Long-Term Medical Treatment in Acromegaly at What Cost? For What Benefits?” 1997. http://www.ncbi.nlm.nih.gov/pubmed/9150692
[18] D. Moore, C. Meads, L. Roberts, F. Song and E. Date, “The Effectiveness and Cost-Effectiveness of Somatostatin Analogues in the Treatment of Acromegaly,” 2002. http://www.crd.york.ac.uk/CRDWeb/ShowRecord.asp?ID=32002000871

  
comments powered by Disqus

Copyright © 2019 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.