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Cost-effectiveness of acromegaly treatments: a systematic review

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Abstract

Purpose

Acromegaly is a rare disease that results in the enlargement of body extremities and in organomegaly. Treatments include surgery, drugs, and radiotherapy, which are all onerous. Therefore, well-conducted cost-analyses are crucial in the decision-making process.

Methods

A systematic review of cost-effectiveness studies on acromegaly therapies was performed following PRISMA and Cochrane recommendations. The search for records was conducted in PubMed, Scopus, and Web of Science (May 2018). The quality of the included studies was assessed using the Joana Briggs Institute Tool.

Results

From initial 547 records, 16 studies were included in the review. The studies could present more than one economic evaluation, and encompassed cost-effectiveness (n = 13), cost-utility (n = 5), and cost-consequence (n = 1) analyses. All studies were model-based and evaluated only direct medical costs. Eleven records did not mention discounting and only 10 performed sensitivity analyses. The characteristic of the studies, the cost-effectiveness results and the studies’ conclusions are described and commented upon. The main limitation of the studies was discussed and aspects to improve in future studies were pointed out.

Conclusions

Cost-effectiveness studies on acromegaly have been performed in several scenarios, evaluating different phases of treatment. However, the studies present limitations and, overall, were considered of moderate quality. Further economic models should be developed following health economics guidelines recommendations, and must improve transparency.

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Acknowledgements

The authors would like to thank the Brazilian National Counsel of Technological and Scientific Development (CNPq) and the Coordination for the Improvement of Higher Education Personnel (CAPES) for providing scholarships.

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Authors and Affiliations

  1. Graduate Program in Pharmaceutical Sciences, Universidade Federal do Paraná, Curitiba, Paraná, Brazil

    Letícia P. Leonart, Vinicius L. Ferreira, Bruno S. Riveros & Roberto Pontarolo

  2. Department of Pharmacy, Universidade Federal do Paraná, Street Pref. Lothário Meissner, 632, Curitiba, Paraná, 80210-170, Brazil

    Helena H. L. Borba & Roberto Pontarolo

Authors
  1. Letícia P. Leonart
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  2. Helena H. L. Borba
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  3. Vinicius L. Ferreira
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Correspondence to Roberto Pontarolo.

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This article does not contain any studies with human participants performed by any of the authors.

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Leonart, L.P., Borba, H.H.L., Ferreira, V.L. et al. Cost-effectiveness of acromegaly treatments: a systematic review. Pituitary 21, 642–652 (2018). https://doi.org/10.1007/s11102-018-0908-0

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