Cost-effectiveness Analysis of NSAIDs Compared with Derris scandens (Roxb.) Benth. in Treatment of Knee Osteoarthritis
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Abstract
Objective: To evaluate cost-effectiveness of the use of Derris scanden (Roxb.) Benth. extracts (Derris) compared to the use of non-steroidal anti-inflammatory drugs ( NSAIDs ) in patients with knee osteoarthritis (OA). Methods: The study was a cost-utility analysis based on decision tree and Markov models from societal perspective. This study compared the use of Derris to the use of NSAIDs with life-time horizon. Costs in th study included costs of OA treatment and gastro-intestinal tract (GI) side effect treatment obtained from database of Lampang Hospital database and discounted in the value in 2017. Utilities and probabilities were obtained from literature reviews. The study measured effectiveness in terms of quality-adjusted life year (QALY) and calculated incremental cost-effectiveness ratio (ICER). Costs and outcomes were discounted at the rate of 3% per annum. One-way sensitivity analyses of all variables were presented in a tornado diagram. A probabilistic sensitivity analysis was also performed and presented as the cost-effectiveness plane and cost-effectiveness acceptability (CEAE) curve. Results: Derris yielded greater QALYs (0.256 vs 0.250 year, respectively), but incurred higher costs than NSAIDs (4,498 vs 3,615 Baht, respectively), resulting in ICER of 138,232 Baht/QALY compared to NSAIDs . One-way sensitivity analyses indicated large ICER change was observed when the utility of mild GI side effect changed. Probabilistic sensitivity analyses indicated that when threshold for willingness to pay was raised up to 160,000 Baht/QALY, the chance of Derris being more cost-effective was over 56 percent. At the threshold for willingness to pay lower than 135,000 Baht/QALY, NSAIDs was more cost-effective than Derris. When the threshold was raised up to 135,000 Baht/QALY, Derris treatment was more cost-effective. Conclusion: Derris is a cost-effective treatment for OA when the threshold for willingness to pay is 160,000 Baht/QALY or more under the assumptions used in this study.
Article Details
ผลการวิจัยและความคิดเห็นที่ปรากฏในบทความถือเป็นความคิดเห็นและอยู่ในความรับผิดชอบของผู้นิพนธ์ มิใช่ความเห็นหรือความรับผิดชอบของกองบรรณาธิการ หรือคณะเภสัชศาสตร์ มหาวิทยาลัยสงขลานครินทร์ ทั้งนี้ไม่รวมความผิดพลาดอันเกิดจากการพิมพ์ บทความที่ได้รับการเผยแพร่โดยวารสารเภสัชกรรมไทยถือเป็นสิทธิ์ของวารสารฯ
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