Pharmacoeconomic evidence of bosentan for pulmonary arterial hypertension. (June 2011)

• Record Type: Journal Article
• Authors: Strange, Geoff; Keogh, Anne; Dalton, Brad; Gabbay, Eli
• Is Part Of: Expert review of pharmacoeconomics & outcomes research. Volume 11:Number 3(2011)
• Page Start: 253
• Page End: 263
• Publication Date: 2011-06
• Subjects: cost––effectiveness -- endothelin receptor antagonists -- incremental cost––effectiveness ratio -- phosphodiesterase inhibitors -- pulmonary arterial hypertension -- quality-adjusted life years; Pharmacology -- Economic aspects -- Periodicals; 338.47615105
• DOI: 10.1586/erp.11.26
• Languages: English
• ISSNs: 1473-7167

Abstract

In this article, we review randomized controlled trials, open-label trials and pharmacoeconomic models of bosentan for the management of patients with pulmonary arterial hypertension. Bosentan consistently improves WHO functional class and quality of life, slows clinical worsening and is associated with improved survival compared with historical treatment. Although head-to-head trials are scarce, data directly comparing bosentan with sildenafil indicate no clinically significant differences between treatments as measured by the 6-min walk distance alone. Compared with historical care, bosentan treatment, over a 15––30-year period, increases the number of quality-adjusted life years (3.49 years). Economic modeling suggests that the cost––effectiveness of bosentan is similar to that of ambrisentan (US$43, 725––57, 778 per quality-adjusted life year), not as cost effective as sildenafil (at 20 mg three-times daily) and more cost effective than iloprost. More randomized controlled trials of longer duration are required to confirm the results from these economic models.