Cost-Utility of Terlypressin in the Treatment of Esophageal and Gastric Variceal Bleeding / 中国药学杂志

ABSTRACT

OBJECTIVE: To evaluate the cost-utility of terlypressin compared with somatostatin in the treatment of esophageal and gastric variceal bleeding(EGVB) in China. METHODS: A discrete event simulation model was created with four transition states bleeding, no bleeding, rebleeding, and death. Transition probability of the model is derived from Meta analysis of the published literature. Used to calculate the quality of life in transition states health utility value source of literature. Cost data was sourced from (the listing price) of medical institutions. One-way sensitivity analyses were performed. RESULTS: In the base case scenario, results showed that terlypressin was more costly and more effective compared with somatostatin, and that incremental cost-utility ratios were 65 478.84 Yuan/QALY. Sensitivity analyses showed that the model was robust, and that all incremental cost-utility ratios were below 110 289.46 Yuan/QALYs, which is far less than three times gross domestic product (GDP) per capita in China. If using the treatment duration in the instructions to calculate drug costs in the sensitivity analysis, treatment with terlypression has lower cost and better effectiveness. CONCLUSION: The model indicates that terlypressin is most likely to be cost-effective versus somatostatin.