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Cost-Benefit Analysis of Amtolmetin-Guacil

  • Clinical Pharmacoeconomics
  • Published:
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Abstract

Objective

To assess the economic profile of amtolmetin-guacil (AMG).

Design

The analytical framework of this study was a cost-benefit analysis.

Setting

Using published trials focusing on the gastrointestinal tolerability of AMG versus other nonsteroidal anti-inflammatory drugs (NSAIDs), we assessed the economic profile of AMG in comparison with tolmetin, indomethacin, diclofenac and piroxicam.

Patients

NSAID users from published randomised controlled trials (RCTs) and meta-analyses used for the present evaluation.

Interventions

AMG vs piroxicam, AMG vs diclofenac, AMG vs indomethacin, AMG vs tolmetin.

Main Outcome Measures

The cost of NSAIDs in managing gastrointestinal lesions was considered. According to the cost-benefit analysis design, the effect was expressed as net cost or benefit consequent to the use of AMG vs other NSAIDs.

Results

The cost of managing gastrointestinal lesions has been estimated to range between L879 400 (EUR454) and L9 176 600 (EUR4740) [year of costing 2000], depending on the grade of severity considered. Compared with tolmetin, the net benefit of using AMG ranged (over 90 days) from a maximum of L4 243 530 (EUR2190) to a minimum of L793 246 (EUR410). With indomethacin, benefits ranged after 30 days from L6 064 058 (EU3132) to L2 026 644 (EUR1046). Similarly, compared with diclofenac, the savings were (over 28 to 30 days) between L3 301 962 (EUR1705) and L736 938 (EUR380). When compared with piroxicam, after 14 days savings reached a minimum of L290 229 (EUR150) and a maximum of L2 178 944 (EUR1077) [year of costing 2000].

Conclusions

Although further research is needed, from this study AMG appears to have a desirable economic profile compared with the other NSAIDs investigated in this study.

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Notes

  1. 1The experts were asked to describe how lesions are treated by means of a subset of questions listed in the appendix.

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Acknowledgements

This research was supported by an unrestricted grant from Sigma-Tau Industrie Farmaceutiche Riunite. We thank the panelists for their patience and their valuable collaboration.

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Authors and Affiliations

  1. Center of Pharmacoeconomics, University of Milan, Via Balzaretti, 9, 20146, Milan, Italy

    Andrea Belisari & Lorenzo Giovanni Mantovani

Authors
  1. Andrea Belisari
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  2. Lorenzo Giovanni Mantovani
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Corresponding author

Correspondence to Lorenzo Giovanni Mantovani.

Appendix I

Appendix I

Information regarding the patterns of care for gastrointestinal lesions resulting from the use of NSAIDs was gathered by interviewing five clinicians by means of a semistructured questionnaire. The classification of the severity of lesions was based on Lanza’s scoring system.[18]

For each grade of severity we asked questions about the management of a single episode, in terms of:

  • • number of patients that needed ambulatory care and type of procedure

  • • number of patients that needed hospitalisation and type of admission by means of DRG (diagnostic-related group) codes

  • • drug treatment, with type of drug, average dose and length of treatment

  • • number and type of laboratory tests and diagnostic procedures needed to manage the patients.

The cost to treat a lesion according to severity was calculated for each one of the panelists interviewed.

The use of resources estimated by each clinician to treat one episode was quantified in monetary terms.

Hospitalisation (long-term and day-hospital) was quantified by means of DRGs published by the Italian Department of Health.[20]

Laboratory examinations, diagnostic procedures, ambulatory treatment and specialist’s visits were quantified according to tariffs published by the Italian Department of Health[19] (Appendix tables I and II).

Appendix table I
figure Tab9

Unit costs for hospital admission. Costs are expressed as Italian Lire (L). EUR1 = L1936

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Appendix table II
figure Tab10

Unit costs for diagnostics. Costs are expressed as Italian Lire (L). EUR1 = L1936

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Drugs needed to care for each episode and according to lesion severity were identified by name, dose, length of treatment and percentage of patients with a prescription. For each active principle, an average cost per milligram was calculated using the price of marketed drugs reported by the National Drug Formulary (NDF).

Appendix table III presents the use of resources broken into diagnostics, visits, ambulatory and hospital treatment.

Appendix table III
figure Tab11

Average use of resourcesa (± SD) by stage of severity as reported by the study panelists

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Diagnostic procedures and visits are presented as units needed for one episode, while ambulatory and hospital treatment are expressed as percentage of patients expected to receive each treatment.

Appendix table IV shows the breakdown of costs and the total cost according to severity of lesion. A minimum-maximum range of cost is also presented according to the panelists’ responses.

Appendix table IV
figure Tab12

Breakdown of costsa to treat lesions by item of cost and severity of lesion

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Belisari, A., Mantovani, L.G. Cost-Benefit Analysis of Amtolmetin-Guacil. Clin. Drug Investig. 21, 47–58 (2001). https://doi.org/10.2165/00044011-200121010-00007

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