Cost-effectiveness of ursodeoxycholic acid therapy in primary biliary cirrhosis

Tousif Pasha, Jenny Heathcote, Sherine Gabriel, Karen Cauch-Dudek, Roberta Jorgensen, Terry Therneau, E. Rolland Dickson, Keith Lindor

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Ursodeoxycholic acid (UDCA) is a safe and effective treatment for patients with primary biliary cirrhosis (PBC), but the cost of this drug has raised concerns regarding cost-effectiveness. The aim of our study was to determine the cost-effectiveness of UDCA in PBC. We compared the costs and outcomes of managing PBC patients with and without UDCA. From two previously published trials, the effectiveness of UDCA was determined by comparing the annual reduction in the development of ascites, varices, variceal bleeding, encephalopathy, liver transplantation, and death between the treatment groups. Average annual costs for each of these events were estimated based on literature and institutional data. Approximately twice as many major events occurred in the placebo group compared with the UDCA group. The relative risk (RR) of liver transplantation (1.95; 95% CI: 1.14-3.68) and development of esophageal varices (3.11; 95% CI: 1.57-10.65) were significantly higher in the placebo group compared with the UDCA group. There were no significant increases in the RR of ascites, variceal bleeding, encephalopathy, or death between the two groups. Based on the estimated annual cost of managing these events and the annual costs of UDCA ($2,500), there was an annual cost savings per patient of $1,372. Compared with the placebo group, patients receiving UDCA had a lower incidence of major complications and lower medical care costs.

Original languageEnglish (US)
Pages (from-to)21-26
Number of pages6
JournalHepatology
Volume29
Issue number1
DOIs
StatePublished - 1999
Externally publishedYes

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Ursodeoxycholic Acid
Biliary Liver Cirrhosis
Cost-Benefit Analysis
Costs and Cost Analysis
Placebos
Brain Diseases
Therapeutics
Ascites
Liver Transplantation
Hemorrhage
Drug Costs
Esophageal and Gastric Varices
Cost Savings
Varicose Veins
Health Care Costs
Incidence

ASJC Scopus subject areas

  • Hepatology

Cite this

Pasha, T., Heathcote, J., Gabriel, S., Cauch-Dudek, K., Jorgensen, R., Therneau, T., ... Lindor, K. (1999). Cost-effectiveness of ursodeoxycholic acid therapy in primary biliary cirrhosis. Hepatology, 29(1), 21-26. https://doi.org/10.1002/hep.510290116

Cost-effectiveness of ursodeoxycholic acid therapy in primary biliary cirrhosis. / Pasha, Tousif; Heathcote, Jenny; Gabriel, Sherine; Cauch-Dudek, Karen; Jorgensen, Roberta; Therneau, Terry; Rolland Dickson, E.; Lindor, Keith.

In: Hepatology, Vol. 29, No. 1, 1999, p. 21-26.

Research output: Contribution to journalArticle

Pasha, T, Heathcote, J, Gabriel, S, Cauch-Dudek, K, Jorgensen, R, Therneau, T, Rolland Dickson, E & Lindor, K 1999, 'Cost-effectiveness of ursodeoxycholic acid therapy in primary biliary cirrhosis', Hepatology, vol. 29, no. 1, pp. 21-26. https://doi.org/10.1002/hep.510290116
Pasha T, Heathcote J, Gabriel S, Cauch-Dudek K, Jorgensen R, Therneau T et al. Cost-effectiveness of ursodeoxycholic acid therapy in primary biliary cirrhosis. Hepatology. 1999;29(1):21-26. https://doi.org/10.1002/hep.510290116
Pasha, Tousif ; Heathcote, Jenny ; Gabriel, Sherine ; Cauch-Dudek, Karen ; Jorgensen, Roberta ; Therneau, Terry ; Rolland Dickson, E. ; Lindor, Keith. / Cost-effectiveness of ursodeoxycholic acid therapy in primary biliary cirrhosis. In: Hepatology. 1999 ; Vol. 29, No. 1. pp. 21-26.
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