Back to Search
Start Over
Cost-utility analysis of rimonabant in the treatment of obesity.
- Source :
-
Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research [Value Health] 2008 May-Jun; Vol. 11 (3), pp. 389-99. Date of Electronic Publication: 2007 Dec 18. - Publication Year :
- 2008
-
Abstract
- Objective: To estimate the incremental cost-utility ratio (ICUR) of rimonabant 20 mg/day in the treatment of obesity from a third-party payer's perspective.<br />Methods: Pooled data from three randomized clinical trials were used to develop a decision tree with five treatment alternatives: 1- and 2-year treatment with rimonabant, 2-year placebo, 1-year rimonabant followed by 1-year placebo, and no treatment. All alternatives, except no treatment, were accompanied by lifestyle interventions. Treatment benefits included gains in quality-adjusted life-years (QALYs) and reduced incidence of type-2 diabetes mellitus and coronary heart disease (CHD). Drug acquisition cost was based on the average wholesale price of a comparator drug minus 15%. One-way and probabilistic sensitivity analyses were conducted to assess the stability of the base-case results.<br />Results: One-year rimonabant and 1-year rimonabant followed by placebo were extensively dominated. Rimonabant for 2 years showed an average weight reduction of 8.49 kg, a body mass index reduction of 2.98 kg/m(2) and reduced waist circumference by 8.24 cm (placebo: 3.55 kg, 1.22 kg/m(2), 4.18 cm). Two-year rimonabant was associated with a relative reduction in the 5-year incidence of CHD by 7.15% and of diabetes by 9.28%. Incremental benefits (costs) were 0.0984 QALYs ($5209) compared to no treatment and 0.0581 QALYs ($4182) compared to placebo, producing ICURs of $52,936/QALY (95% confidence interval $39K-$69K) and $71,973/QALY ($51K-$98K), respectively.<br />Conclusions: Rimonabant combined with lifestyle interventions has the potential to decrease the rate of obesity-related comorbidities and improve health-related quality of life, albeit at considerable cost.
- Subjects :
- Cost-Benefit Analysis
Decision Trees
Female
Humans
Male
Middle Aged
Models, Economic
Quality-Adjusted Life Years
Randomized Controlled Trials as Topic
Rimonabant
Treatment Outcome
Anti-Obesity Agents economics
Anti-Obesity Agents therapeutic use
Obesity drug therapy
Obesity economics
Piperidines economics
Piperidines therapeutic use
Pyrazoles economics
Pyrazoles therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1524-4733
- Volume :
- 11
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research
- Publication Type :
- Academic Journal
- Accession number :
- 18179661
- Full Text :
- https://doi.org/10.1111/j.1524-4733.2007.00281.x