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Cost-Effectiveness of Linaclotide Compared to Osmotic Laxatives in the Treatment of Irritable Bowel Syndrome with Constipation in China

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A Correction to this article was published on 28 July 2022

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Abstract

Introduction

Linaclotide, a selective agonist of guanylate cyclase C, was highly recommended for the treatment of irritable bowel syndrome with constipation (IBS-C). However, the cost-effectiveness of linaclotide in Chinese is not known, and this study aimed to assess the cost-effectiveness of linaclotide for patients with IBS-C.

Methods

An economic evaluation was conducted with a Markov model from a societal perspective. The Markov model was structured to simulate the discontinuation and continuation of medication in IBS-C patients in clinical practice, as well as the revisit and non-visit of non-responding patients. The cycle of the model was 4 weeks, and the time horizon was 1 year. The efficacy data in the model was from the risk ratios obtained by the meta-analysis and the calculation of the response rate of the three medications. The utility, discontinuation rate of the medication, and revisit rate data were from published literature, while the cost data were obtained from experts’ opinions and published literature. A series of sensitivity analyses was performed on parameters potentially having impact on the model outputs.

Results

The QALYs (quality-adjusted life years) gained for 1-year treatment with linaclotide, polyethylene glycol, and lactulose were 0.821, 0.795, and 0.781, respectively. The corresponding total costs were CNY 7,721 (USD 1,120), CNY 8,797 (USD 1,276) and CNY 9,481 (USD 1,375). In both comparisons, linaclotide was dominant. Compared with polyethylene glycol and lactulose, the likelihood of linaclotide being cost-effective was 100% for both, using 1 times per capita GDP per QALY as willingness-to-pay threshold.

Conclusions

IBS-C seriously affects the quality of life of patients with IBS-C, and linaclotide can improve symptoms and quality of life at less cost.

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References

  1. Ford AC, Moayyedi P, Chey WD, Harris LA, Lacy BE, Saito YA, et al. American College of Gastroenterology monograph on management of irritable bowel syndrome. Am J Gastroenterol. 2018;113(Suppl 2):1–18.

    Article  Google Scholar 

  2. Chinese Society of Gastroenterology. Expert consensus on irritable bowel syndrome in China (Shanghai, 2015). Chin J Dig. 2016;36(05):299–312.

    Google Scholar 

  3. Shang-ru C, Gang-feng L, Jun-xiong L, Chao Z, Guo-lian L, Guang-hua LI, et al. An analysis of quality of life and mental characteristics in patients with various subtype irritable bowel syndrome. J Youjiang Med Univ Nationalities. 2009;31(6):945–7.

    Google Scholar 

  4. Mearin F, Ciriza C, Minguez M, Rey E, Mascort JJ, Pena E, et al. Clinical practice guideline: irritable bowel syndrome with constipation and functional constipation in the adult. Rev Esp Enferm Dig. 2016;108(6):332–63.

    PubMed  Google Scholar 

  5. Lu Z, Liping D, Yixuan L, Yuxin L, Hua Z, Zuojing L, et al. A meta-analysis of the prevalence and risk factors of irritable bowel syndrome in Chinese community. Chin J Intern Med. 2014;53(12):969–75.

    Google Scholar 

  6. Li X, Chang M, Xu D, Fang X. The current status of the epidemiological study of irritable bowel syndrome in China. Chin J Gastroenterol Hepatol. 2013;22(08):734–9.

    Google Scholar 

  7. Yao M, Chen Y, Zhou H, Song Y, Li D. An epidemiological study of irritable bowel syndrome in adolescents in southern China. J Clin Pediatr. 2007;10:835–9.

    Google Scholar 

  8. Long Y, Huang Z, Deng Y, Chu H, Zheng X, Yang J, et al. Prevalence and risk factors for functional bowel disorders in South China: A population based study using the Rome III criteria. Neurogastroenterol Motil. 2017;29(1): e12897.

    Article  Google Scholar 

  9. Wu B. PGI35 real-world medication use and cost of illness in irritable bowel syndrome with constipation in the Chinese setting. Value Health. 2020;23(Suppl 1):S149.

    Google Scholar 

  10. Park JM, Choi MG, Kim YS, Choi CH, Choi SC, Hong SJ, et al. Quality of life of patients with irritable bowel syndrome in Korea. Qual Life Res. 2009;18(4):435–46.

    Article  Google Scholar 

  11. Duowu Z. Linaclotide: a novel option for chronic constipation and constipation-type irritable bowel syndrome. Chin J Dig. 2019;04:286–8.

    Google Scholar 

  12. Fisher M, Walker A, Falqués M, Moya M, Rance M, Taylor D, et al. Cost-effectiveness of linaclotide compared to antidepressants in the treatment of irritable bowel syndrome with constipation in Scotland. Eur J Health Econ. 2016;17(9):1091–100.

    Article  Google Scholar 

  13. Fisher M, Falqués M, Rance M, Taylor D, Lindner L. Cost-effectiveness of linaclotide compared to antidepressants in the treatment of irritable bowel syndrome with constipation in Scotland. Value Health. 2013;16(9):A497.

    Article  Google Scholar 

  14. Almeida J, Vandewalle B, Félix J. Cost-effectiveness of linaclotide: a valuable option in the treatment of irritable bowel syndrome. Value Health. 2014;17(7):A366.

    Article  CAS  Google Scholar 

  15. Huang H, Taylor DC, Carson RT, Sarocco P, Friedman M, Munsell M, et al. Economic evaluation of linaclotide for the treatment of adult patients with irritable bowel syndrome with constipation in the United States. J Med Econ. 2015;18(4):283–94.

    Article  Google Scholar 

  16. Guo'en L, Shanlian H, Jiuhong W. Chinese Pharmacoeconomic Evaluation Guide 2020 Edition. China Market Press; 2020.

  17. National Bureau of Statistics. Statistical Bulletin of the People's Republic of China on National Economic and Social Development 2019; 2020.

  18. Yang Y, Fang J, Guo X, Dai N, Shen X, Yang Y, et al. Linaclotide in irritable bowel syndrome with constipation: a phase 3 randomized trial in China and other regions. J Gastroenterol Hepatol. 2018;33:980–9.

    Article  CAS  Google Scholar 

  19. Chapman RW, Stanghellini V, Geraint M, Halphen M. Randomized clinical trial: macrogol/PEG 3350 plus electrolytes for treatment of patients with constipation associated with irritable bowel syndrome. Am J Gastroenterol. 2013;108(9):1508–15.

    Article  CAS  Google Scholar 

  20. Lee-Robichaud H, Thomas K, Morgan J, Richard LN. Lactulose versus polyethylene glycol for chronic constipation. Cochrane Database Syst Rev. 2010(7).

  21. U.S Food and Drug Administration CfDEaR. Guidance for industry: Irritable Bowel Syndrome—clinical evaluation of drugs for treatment. U.S Department of Health and Human Services; 2012.

  22. Chey WD, Lembo AJ, Lavins BJ, Shiff SJ, Kurtz CB, Currie MG, et al. Linaclotide for irritable bowel syndrome with constipation: a 26-week, randomized, double-blind, placebo-controlled trial to evaluate efficacy and safety. Am J Gastroenterol. 2012;107(11):1702–12.

    Article  CAS  Google Scholar 

  23. Jiantang M. The sixth national census.

  24. Abbott. Duphalac (Lactulose Oral Solution) Drug label.

  25. Zhang F, Xiang W, Li CY, Li SC. Economic burden of irritable bowel syndrome in China. World J Gastroenterol. 2016;22(47):10450–60.

    Article  Google Scholar 

  26. Fisher M, Walker A, Falques M, Ran Ce M, Taylor D, Lindner L. PWE-175 cost-effectiveness of linaclotide (LIN) compared to antidepressants (ATDS) in the treatment of irritable bowel syndrome with constipation (IBS-C) in Scotland. Gut. 2014;63(Suppl 1):A202.

    Article  Google Scholar 

  27. National Healthcare Security Administration. Circular of the Ministry of Human Resources and Social Security of the State Administration of Medical Insurance on Printing and Distributing Catalogue of Drugs for National Basic Medical Insurance Injury Insurance and Maternity Insurance (2020).

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Acknowledgements

Funding

This work was supported by AstraZeneca Pharmaceutical Co Ltd. The journal’s Rapid Service Fee was funded by the authors.

Authorship

All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

Author Contributions

All authors contributed to the study conception and design. Prof. Xuan and Prof. Chen was responsible for the conception and design of the study. Prof. Xuan was responsible for obtaining funding. Mr. Xiao was responsible for the analysis and interpretation of the data. Mrs. Yue and Mrs. Chen was responsible for the collection and assembly of data, as well as the writing of the manuscript. The manuscript has been read and approved by all the authors, that all journal requirements for authorship have been met, and that each author believes that the manuscript represents honest work.

Disclosures

Dunming Xiao, Yue Zhang, Wanxin Chen, Jianwei Xuan and Yingyao Chen all have nothing to disclose. The funding agencies had no role in the study design, data collection and analysis, decision to publish, or manuscript preparation.

Compliance with Ethics Guidelines

This article is based on previously conducted studies and does not contain any new studies with human participants or animals performed by any of the authors.

Data availability

Data sharing is not applicable to this article as no datasets were generated or analyzed during the current study.

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Correspondence to Jianwei Xuan or Yingyao Chen.

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Xiao, D., Zhang, Y., Chen, W. et al. Cost-Effectiveness of Linaclotide Compared to Osmotic Laxatives in the Treatment of Irritable Bowel Syndrome with Constipation in China. Adv Ther 39, 2971–2983 (2022). https://doi.org/10.1007/s12325-022-02161-x

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