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Ambrisentan for in pediatric pulmonary arterial hypertension: A cost-utility analysis
Jefferson A Buendía1, Diana G Patiño1, Erika F Lindarte1
1Research Group in Pharmacology and Toxicology"INFARTO", Department of Pharmacology and Toxicology, University of Antioquia, Medellin, Colombia.
Insights
Sildenafil is more cost-effective than ambrisentan for treating pediatric pulmonary arterial hypertension in Colombia. This study found sildenafil offers better economic value and quality of life improvements for these patients.
Area of Science:
- Pharmacoeconomics
- Pediatric Cardiology
- Health Technology Assessment
Background:
- Pulmonary arterial hypertension (PAH) in children requires effective treatment.
- Ambrisentan's cost-effectiveness compared to sildenafil in pediatric PAH is not well-established.
- Understanding treatment economics is crucial for healthcare decision-making in Colombia.
Purpose of the Study:
- To determine the cost-utility of ambrisentan versus sildenafil for pediatric PAH patients in Colombia.
- To evaluate the economic impact of ambrisentan in improving functional classes and reducing costs.
- To provide evidence for optimizing clinical practice guidelines.
Main Methods:
- A decision tree model was employed to assess costs and quality-adjusted life-years (QALYs).
- Comparative analysis of ambrisentan and sildenafil treatment strategies.
- Sensitivity analyses were performed to ensure model robustness.
- Cost-effectiveness was evaluated against a willingness-to-pay threshold of US$5180.
Main Results:
- Ambrisentan demonstrated higher costs (US$16,105 annually) compared to sildenafil (US$1431 annually).
- Ambrisentan yielded slightly higher QALYs (0.40) than sildenafil (0.39).
- Sildenafil showed economic dominance due to improved quality of life and lower costs.
Conclusions:
- Ambrisentan is not cost-effective compared to sildenafil for pediatric PAH in Colombia.
- Sildenafil presents a more economically favorable option for treating pediatric PAH.
- Findings support informed decision-making for clinical practice guidelines in pediatric PAH management.
Introduction:
Despite the growing evidence of efficacy, little is known regarding the efficiency of ambrisentan to decrease cost and improve the functional classes of pediatric patients with pulmonary arterial hypertension. This study aims to determine the cost-utility of ambrisentan regarding sildenafil to treat pediatric patients with pulmonary arterial hypertension in Colombia.
Methods:
A decision tree model was used to estimate the cost and quality-adjusted life-years (QALYs) of ambrisentan, or sildenafil in pediatric patients with pulmonary arterial hypertension. Multiple sensitivity analyses were conducted to evaluate the robustness of the model. Cost-effectiveness was evaluated at a willingness-to-pay (WTP) value of US$5180.
Results:
The base-case analysis showed that compared with sildenafil, ambrisentan was associated with higher costs and higher QALYs. The expected annual cost per patient with ambrisentan was US$16,105 and with sildenafil was US$1431. The QALYs per person estimated with ambrisentan was 0.40 and for sildenafil was 0.39. The estimated improvement in quality of life and reduced costs results in an estimate of economic dominance for sildenafil over ambrisentan.
Conclusion:
Our economic evaluation shows that ambrisentan is not cost-effective regarding sildenafil to treat pediatric patients with pulmonary arterial hypertension in Colombia. Our study provides evidence that should be used by decision-makers to improve clinical practice guidelines.
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