Pharmacoeconomic analysis of medicines used in the treatment of pulmonary hypertension in the Russian Federation
This article provides a comparative pharmacoeconomic evaluation of ambrisentan and bosentan used in the treatment of patients with functional class II or III pulmonary arterial hypertension (PAH) in Russia. The evaluation included methods of cost analysis, cost -minimization analysis, cost-utility analysis and budget impact analysis. The cost analysis revealed that the Volibris (ambrisentan) and Tracleer (bosentan) – associated costs, based on the per-patient per year treatment cost for one patient with PAH regardless of its functional class, were 1 585 649 rubles and 2 488 878 rubles, respectively. The results of cost-minimization analysis, based on the assumption of equal effectiveness of compared drugs, have shown that the per-patient per year treatment costs for Volibris (ambrisentan) allow cost savings of 909 789 rubles as compared to Tracleer (bosentan). The values of a cost-utility analysis for Volibris (ambrisentan) appeared to be lower than those for Tracleer (bosentan). For the former, depending on the functional class of the disease and drug dosage, the values of a cost-utility analysis varied from 2 321 771 rubles to 3 535 685 rubles per QALY, whereas for Tracleer (bosentan) the corresponding values were 4 335 477 rubles and 5 718 143 rubles per QALY in patients with functional class II PAH and functional class III PAH, respectively. The budget impact analysis, based on the estimated number of patients with PAH in RF of 3292 subjects, has shown that the total annual costs for Tracleer (bosentan) would be 8,193 billion rubles versus 5,219 billion rubles had the same patients been treated with Volibris (ambrisentan). Therefore, the possible cost savings with Volibris (ambrisentan) would be 2,973 billion rubles had it been used instead of Tracleer (bosentan), thus indicating that from the pharmacoeconomic perspective treatment with Volibris (ambrisentan) is a dominant choice.
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