Cost-utility of ambrisentan and bosentan for pediatric pulmonary arterial hypertension

ABSTRACT

Introduction

Despite the increasing evidence supporting the efficacy of ambrisentan and bosentan in improving functional classes among pediatric patients with pulmonary arterial hypertension (PAH), there is a lack of information regarding their cost implications. Therefore, the objective of this study is to assess the cost-utility of bosentan compared to ambrisentan for the treatment of pediatric patients with PAH in Colombia.

Methods

We employed a Markov model to estimate the costs and quality-adjusted life-years (QALYs) associated with the use of ambrisentan or bosentan in pediatric patients diagnosed with pulmonary arterial hypertension (PAH). To ensure the reliability of our findings, we conducted sensitivity analyses to assess the robustness of the model. In our cost-effectiveness analysis, we evaluated the outcomes at a willingness-to-pay (WTP) threshold of US$5,180.

Results

The expected annual cost per patient receiving ambrisentan was estimated to be $16,055 (95% CI 15,937 –16,172), while for bosentan it was $14,503 (95% CI 14,489 –14,615). The QALYs per person estimated for ambrisentan were 0.39 (95% CI 0.381–0.382), whereas for bosentan it was 0.40 (95% CI 0.401–0.403).

Conclusion

Our economic evaluation shows that ambrisentan is not cost-effective regarding bosentan to in treating pulmonary arterial hypertension in C.

KEYWORDS:

• health economics
• public health
• healthcare
• Colombia
• bosentan
• ambrisentan

List of abbreviations

PAH Pulmonary arterial hypertension

FC functional class

RR relative risk

RTC a randomized controlled trial

WTP willingness-to-pay

QALY quality adjusted life years

ICER incremental cost effectiveness ratio

NMB net monetary benefit

INMB incremental net monetary benefit

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Availability of data and material

Bosentan pediatrics (Version 2) [Data set]. Zenodo. https://doi.org/10.5281/zenodo.6615465

Additional information

Funding

This paper was not funded.