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Cost Effectiveness of Emedastine versus Levocabastine in the Treatment of Allergic Conjunctivitis in 7 European Countries

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Abstract

Objective: To assess the cost effectiveness of emedastine, a new antihistamine, versus levocabastine in the treatment of acute allergic conjunctivitis (AAC) in Belgium, France, Germany, The Netherlands, Norway, Portugal and Sweden.

Design and setting: Randomised double-blind multicountry clinical trial followed by economic modelling from the treatment provider perspective.

Patients: A total of 221 patients (109 emedastine, 112 levocabastine) with AAC were included.

Methods: The clinical trial compared the efficacy and safety of emedastine 0.05% and levocabastine 0.05%, both twice daily, for 42 days, using ocular redness, itching, days without symptoms and clinical failure as outcome measures. The cost of first-line treatment failure, including visits, drugs and laboratory examinations, was established in each country from a panel of ophthalmologists and general practitioners. Full sensitivity analyses were conducted.

Results: From day 7 to 42, patients treated with emedastine had less itching (p < 0.001) and less redness (p < 0.001). The failure rate was 10% less (p < 0.02) with emedastine and patients treatedwith emedastine had an incremental 8.5 days (p < 0.01) without symptoms. Emedastine and levocabastine were equally well tolerated. In all European countries, the cost of failurewas lower with emedastine. Emedastine was found to be economically dominant relative to levocabastine, i.e. more effective and less expensive, in Belgium, Germany, Portugal and Sweden; in France, The Netherlands and Norway the incremental cost was low (less than 1 euro per additional symptom-free day).

Conclusion: Through a model based on a randomised clinical trial and cost estimates of treatment failure derived from practitioner interviews, emedastine is a cost-effective treatment of AAC.

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Acknowledgements

The clinical trial was supported by an unrestricted grant from Alcon Laboratories Inc., Fort Worth, Texas, USA, and was conducted according to the local laws of each participating country. The economic analysis was supported by an unrestricted grant from Alcon France SA, Rueil-Malmaison, France.

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Authors and Affiliations

  1. Instituto Superior de Economia e Gestao, Universade Técnica de Lisboa, Lisboa, Portugal

    Carlos Gouveia Pinto

  2. Cemka, Bourg-la-Reine, France

    Antoine Lafuma & Francis Fagnani

  3. Medtap Netherlands, Jisp, The Netherlands

    Mark J. C. Nuijten

  4. Alcon France, Rue Henri Sainte-Claire Deville 4, F-92563, Rueil-Malmaison Cedex, France

    Gilles Berdeaux

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  1. Carlos Gouveia Pinto
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  2. Antoine Lafuma
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Correspondence to Gilles Berdeaux.

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Pinto, C.G., Lafuma, A., Fagnani, F. et al. Cost Effectiveness of Emedastine versus Levocabastine in the Treatment of Allergic Conjunctivitis in 7 European Countries. Pharmacoeconomics 19, 255–265 (2001). https://doi.org/10.2165/00019053-200119030-00004

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