The cost-effectiveness of sildenafil

Area of Science:

• Pharmacoeconomics
• Health Economics
• Urology

Background:

• Coverage of sildenafil by health insurance plans remains a contentious issue.
• Erectile dysfunction affects a significant population, necessitating cost-effective treatment options.

Purpose of the Study:

• To evaluate the cost-effectiveness of sildenafil for treating erectile dysfunction.
• To compare the economic value of sildenafil against no drug therapy from societal and third-party payer perspectives.

Main Methods:

• A Markov decision model was utilized to estimate the incremental cost-effectiveness ratio.
• Data on sildenafil's efficacy, safety, and quality-of-life utilities were sourced from published medical literature.
• The analysis focused on hypothetical cohorts of men aged 60 with erectile dysfunction over a lifetime time horizon, with base-case values biased against sildenafil.

Main Results:

• The cost per quality-adjusted life-year (QALY) gained for sildenafil was $11,290 (societal perspective) and $11,230 (third-party payer perspective).
• Sensitivity analyses indicated that sildenafil remained cost-effective (under $50,000 per QALY gained) under various conditions, including lower morbidity/mortality rates, higher success rates, and reduced drug costs.
• Improvements in quality of life utility values of 0.05 or more significantly contributed to the favorable cost-effectiveness.

Conclusions:

• Sildenafil treatment for erectile dysfunction demonstrates favorable cost-effectiveness compared to accepted therapies for other medical conditions.
• Even when analyzed with parameters biased against its use, sildenafil provides economic value.
• The findings support the consideration of sildenafil coverage by health insurance plans based on its demonstrated cost-effectiveness.