| Berni, Ellen, Murphy, Daniel, Whitehouse, James, Conway, Pete, Di Maggio, Paola, Currie, Craig J. and Poole, Chris 2018. Evaluation of the cost-effectiveness of rifaximin-α for the management of patients with hepatic encephalopathy in the United Kingdom. Current Medical Research and Opinion 34 (11) , pp. 2001-2008. 10.1080/03007995.2018.1499506 |
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Abstract
Objective: Rifaximin-α 550 mg twice daily plus lactulose has demonstrated efficacy in reducing recurrence of episodes of overt HE (OHE) and the risk of HE-related hospitalisations compared with lactulose alone. This analysis estimated the cost effectiveness of rifaximin-α 550 mg twice daily plus lactulose versus lactulose alone in UK cirrhotic patients with OHE. Method: A Markov model was built to estimate the incremental cost effectiveness ratio (ICER). The perspective was that of the UK National Health Service (NHS). Clinical data were sourced from a randomised controlled trial (RCT) and an open-label maintenance (OLM) study in cirrhotic patients in remission from recurrent episodes of OHE. Health-related utility was estimated indirectly from disease-specific quality of life RCT data. Resource use data describing the impact of rifaximin-α on hospital admissions and length of stay for cirrhotic patients with OHE were from four single-centre UK audits. Costs (2012) were derived from published sources; costs and benefits were discounted at 3.5%. The base-case time horizon was five years. Results: The average cost per patient was £22,971 in the rifaximin-α plus lactulose arm and £23,545 in the lactulose arm, a saving of £573. The corresponding values for benefit were 2.35 QALYs and 1.83 QALYs per person, a difference of 0.52 QALYs. This translated into a dominant base-case ICER. Key parameters that impacted the ICER included number of hospital admissions and length of stay. Conclusion: Rifaximin-α 550 mg twice daily in patients with recurrent episodes of overt HE was estimated to generate cost savings and improved clinical outcomes compared to standard care over five years.
| Item Type: | Article |
|---|---|
| Date Type: | Publication |
| Status: | Published |
| Schools: | Schools > Medicine |
| Publisher: | Taylor & Francis: STM, Behavioural Science and Public Health Titles |
| ISSN: | 0300-7995 |
| Date of First Compliant Deposit: | 16 July 2018 |
| Date of Acceptance: | 15 February 2018 |
| Last Modified: | 02 Dec 2024 14:15 |
| URI: | https://orca.cardiff.ac.uk/id/eprint/113190 |
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