Economic evaluation of orlistat in overweight and obese patients with type 2 diabetes mellitus.

Abstract:

OBJECTIVE:To estimate the economic value of pharmacological treatment of type 2 diabetes mellitus in overweight and obese patients using orlistat in addition to standard diabetes therapy (i.e., a sulphonlyurea, metformin or insulin) and weight management strategies as compared with standard diabetes therapy and weight management strategies alone in a US-based healthcare setting. The perspective of the study was from the viewpoint of a US healthcare provider. DESIGN AND SETTING:Markov state transition model simulating diabetes-related complications and mortality for a period of 11 years. Patients were modelled to continue orlistat therapy for a 52-week period, assuming a 3-year period of weight regain where after 3 years bodyweight would match that of the placebo group. The impact of orlistat on glycosylated haemoglobin (HbA(1c)) values was evaluated directly using data from four randomised, placebo-controlled, 1-year trials of orlistat in overweight or obese adults with type 2 diabetes who also received standard diabetes pharmacotherapy and intensive lifestyle modification. Incidence rates of micro- and macrovascular complications associated with type 2 diabetes and the estimated relative reduction in incidence rates associated with a decrease in mean updated HbA(1C) values were derived from the United Kingdom Prospective Diabetes Study (UKPDS) estimates for a reference population of male patients, 52 years of age. US cost estimates were derived from published sources and presented in 2001 US dollars. Discounting of 3% was applied. Probabilistic sensitivity analysis was applied to evaluate the robustness of the results of the persistence of the effect of orlistat after treatment. MAIN OUTCOME MEASURES:Average costs and event-free life-years gained during the 11-year period expressed as the incremental costs divided by the incremental gain in life expectancy. RESULTS:Treatment with orlistat, 120 mg three times daily, increased event-free life expectancy by 0.13 years over an 11-year period. Average treatment costs were estimated to be 19,987 US dollars in the orlistat group compared with 18,865 US dollars in the group that received diabetes medication and weight management alone. This translated into a cost-effectiveness ratio of 8327 US dollars per event-free life-year gained. CONCLUSION:Adding orlistat as a pharmacological treatment to conventional diabetes and weight management approaches seems to be a cost-effective treatment option for overweight and obese patients with type 2 diabetes.

journal_name

Pharmacoeconomics

journal_title

PharmacoEconomics

authors

Maetzel A,Ruof J,Covington M,Wolf A

doi

10.2165/00019053-200321070-00005

subject

Has Abstract

pub_date

2003-01-01 00:00:00

pages

501-12

issue

7

eissn

1170-7690

issn

1179-2027

pii

2175

journal_volume

21

pub_type

杂志文章
  • Economic evaluation of insulin lispro versus neutral (regular) insulin therapy using a willingness-to-pay approach.

    abstract::This willingness-to-pay (WTP) analysis is the first study of its kind undertaken in Australia to support an application for listing of a new drug on the Australian national formulary. The technique offers the advantage of being able to summarise diverse outcomes of therapy in a single unit of measure. Willingness to p...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/00019053-199813030-00009

    authors: Davey P,Grainger D,MacMillan J,Rajan N,Aristides M,Dobson M

    更新日期:1998-03-01 00:00:00

  • It's time to choose the study design!: net benefit analysis of alternative study designs to acquire information for evaluation of health technologies.

    abstract::Uncertainty in the decision-making process for reimbursement of health technologies could be reduced if additional information were available. Although methods to evaluate the monetary value of the uncertainty have been previously described, an economic evaluation of alternative methods to acquire additional informati...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章,评审

    doi:10.2165/00019053-200725110-00002

    authors: Shavit O,Leshno M,Goldberger A,Shmueli A,Hoffman A

    更新日期:2007-01-01 00:00:00

  • Impacts of health insurance benefit design on percutaneous coronary intervention use and inpatient costs among patients with acute myocardial infarction in Shanghai, China.

    abstract:BACKGROUND:Currently, the most popular hospital payment method in China is fee-for-service (FFS) with a global budget cap. As of December 2009, a policy change means that heart stents are covered by public health insurance, whereas previously they were not. This policy change provides us an opportunity to study how a c...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.1007/s40273-013-0079-9

    authors: Yuan S,Liu Y,Li N,Zhang Y,Zhang Z,Tao J,Shi L,Quan H,Lu M,Ma J

    更新日期:2014-03-01 00:00:00

  • Cost effectiveness of quetiapine in patients with acute bipolar depression and in maintenance treatment after an acute depressive episode.

    abstract:BACKGROUND:Bipolar disorder has a significant impact upon a patient's quality of life, imposing a considerable economic burden on the individual, family members and society as a whole. Several medications are indicated for the acute treatment of mania and depression associated with bipolar disorder as well as for maint...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/11594930-000000000-00000

    authors: Ekman M,Lindgren P,Miltenburger C,Meier G,Locklear JC,Chatterton ML

    更新日期:2012-06-01 00:00:00

  • Cost-effectiveness analysis of capecitabine compared with bolus 5-fluorouracil/l-leucovorin for the adjuvant treatment of colon cancer in Japan.

    abstract:OBJECTIVE:A cost-effectiveness analysis of oral capecitabine versus intravenous bolus 5-fluorouracil/l-leucovorin (FU/LV) as adjuvant therapy in patients with stage 3 colon cancer was performed from a Japanese healthcare payer perspective. METHODS:Adjuvant therapy comprised 24 weeks of treatment with either oral capec...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/11310110-000000000-00000

    authors: Shiroiwa T,Fukuda T,Shimozuma K,Ohashi Y,Tsutani K

    更新日期:2009-01-01 00:00:00

  • Enoxaparin: a pharmacoeconomic review of its use in the prevention and treatment of venous thromboembolism and in acute coronary syndromes.

    abstract::The pharmacoeconomics of the low molecular weight heparin (LMWH) enoxaparin in the prophylaxis and treatment of venous thromboembolism have mostly been investigated in cost-effectiveness studies that estimated direct costs associated with treatment, using decision analyses and clinical outcome data from randomised con...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/00019053-200220040-00002

    authors: Bergqvist D

    更新日期:2002-01-01 00:00:00

  • Cost-Effectiveness Analysis of Prophylaxis Treatment Strategies to Reduce the Incidence of Febrile Neutropenia in Patients with Early-Stage Breast Cancer or Non-Hodgkin Lymphoma.

    abstract:OBJECTIVE:The objective of this study was to evaluate the cost effectiveness of no prophylaxis, primary prophylaxis (PP), or secondary prophylaxis (SP) with granulocyte colony-stimulating factors (G-CSFs), i.e., pegfilgrastim, lipegfilgrastim, filgrastim (6- and 11-day), or lenograstim (6- and 11-day), to reduce the in...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.1007/s40273-016-0474-0

    authors: Fust K,Li X,Maschio M,Villa G,Parthan A,Barron R,Weinstein MC,Somers L,Hoefkens C,Lyman GH

    更新日期:2017-04-01 00:00:00

  • Reimbursement for new health technologies. Breakthrough pharmaceuticals as a 20th century challenge.

    abstract::The regulation of pricing and trade for in-patent medicines within the European pharmaceutical sector presents a major challenge. In conditions of large sunk costs and consumers with differential willingness to pay--between different Member States--an efficient way of pricing in-patent medicines is through price discr...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/00019053-200018001-00008

    authors: Glynn D

    更新日期:2000-01-01 00:00:00

  • Pharmacoeconomics and health policy. Current applications and prospects for the future.

    abstract::The use of pharmacoeconomic tools has grown dramatically in the past decade as provision of healthcare throughout the industrialised world has required increased cost consciousness. However, pharmacoeconomic analysis has not yet been fully exploited as a conceptual underpinning for public or private health policy deci...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/00019053-199916050-00001

    authors: Greenberg PE,Arcelus A,Birnbaum HG,Cremieux PY,LeLorier J,Ouellette P,Slavin MB

    更新日期:1999-11-01 00:00:00

  • Developing guidance for budget impact analysis.

    abstract::The role of economic evaluation in the efficient allocation of healthcare resources has been widely debated. Whilst economic evidence is undoubtedly useful to purchasers, it does not address the issue of affordability which is an increasing concern. Healthcare purchasers are concerned not just with maximising efficien...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章,评审

    doi:10.2165/00019053-200119060-00001

    authors: Trueman P,Drummond M,Hutton J

    更新日期:2001-01-01 00:00:00

  • Varicella vaccination in Italy : an economic evaluation of different scenarios.

    abstract:AIM:To determine the economic impact (cost-benefit analysis) of childhood varicella vaccination, with the Oka/Merck varicella zoster virus vaccine live (Varivax) in Italy. METHODS:This analysis is based on an epidemiological model of varicella zoster virus (VZV) dynamics adapted to the Italian situation. Cost data (Eu...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/00019053-200422130-00003

    authors: Coudeville L,Brunot A,Giaquinto C,Lucioni C,Dervaux B

    更新日期:2004-01-01 00:00:00

  • Economic evaluation of influenza vaccination and economic modelling. Can results be pooled?

    abstract::Scientific reviewing methods were applied to economic studies of influenza vaccination, and an economic model of influenza vaccination was developed from these primary sources. Issues arising from the secondary literature review include the quality of evidence on the effectiveness of the vaccines, the absence of a tra...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/00019053-199600093-00015

    authors: Jefferson T,Demicheli V

    更新日期:1996-01-01 00:00:00

  • Pharmacoeconomics of intravenous drug administration.

    abstract::Direct administration of a drug into a vein guarantees bioavailability, i.e. the total amount of drug is fully available to the bloodstream for transport to all areas of the body. What is not ensured is the safety, need and 'value for money' of this route. Few workers would disagree that there is increased morbidity...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章,评审

    doi:10.2165/00019053-199201020-00007

    authors: Parker SE,Davey PG

    更新日期:1992-02-01 00:00:00

  • Cost evaluation of basiliximab treatment for renal transplant patients in Japan.

    abstract:BACKGROUND:International phase III studies (CHIB 201 and 352) showed that basiliximab, a high affinity chimeric monoclonal antibody interleukin-2 receptor antagonist, is highly effective in preventing acute rejection when used as immunoprophylaxis in patients receiving cyclosporin (Neoral). We conducted a cost evaluati...

    journal_title:PharmacoEconomics

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.2165/00019053-200321110-00003

    authors: Hasegawa T,Imai H,Miki S

    更新日期:2003-01-01 00:00:00

  • Oral ciprofloxacin: a pharmacoeconomic evaluation of its use in the treatment of serious infections.

    abstract::The broad spectrum of antibacterial activity and favourable pharmacokinetic profile of ciprofloxacin permit oral treatment of many serious infections which have traditionally necessitated parenteral antibacterial therapy. This has been demonstrated in comparative studies, in which ciprofloxacin was as effective and w...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章,评审

    doi:10.2165/00019053-199303050-00007

    authors: Balfour JA,Faulds D

    更新日期:1993-05-01 00:00:00

  • Quality assessment of economic evaluations published in PharmacoEconomics. The first four years (1992 to 1995).

    abstract::Our objective was to assess the quality of reporting of original economic research articles in PharmacoEconomics from inception to the end of 1995, in order to identify areas of strength and weakness, and analyse trends over time. Each regular issue of the journal was examined for original economic evaluations. Accept...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/00019053-199712060-00008

    authors: Iskedjian M,Trakas K,Bradley CA,Addis A,Lanctôt K,Kruk D,Ilersich AL,Einarson TR

    更新日期:1997-12-01 00:00:00

  • Utilities of the EQ-5D: transferable or not?

    abstract:BACKGROUND:Within the framework of economic evaluations, the transferability of utility scores between jurisdictions remains unclear. The EQ-5D is a generic instrument for measuring health-related quality of life in economic evaluations, which can be used for comparing utility scores across countries. At present, the E...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/11314120-000000000-00000

    authors: Knies S,Evers SM,Candel MJ,Severens JL,Ament AJ

    更新日期:2009-01-01 00:00:00

  • Cost effectiveness of venous thromboembolism pharmacological prophylaxis in total hip and knee replacement: a systematic review.

    abstract::Total hip and knee replacements (THR and TKR) are high-risk settings for venous thromboembolism (VTE). This review summarizes the cost effectiveness of VTE prophylaxis regimens for THR and TKR. We searched MEDLINE (January 1997 to October 2009), EMBASE (January 1997 to June 2009) and the UK NHS Economic Evaluation Dat...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章,评审

    doi:10.2165/11535210-000000000-00000

    authors: Kapoor A,Chuang W,Radhakrishnan N,Smith KJ,Berlowitz D,Segal JB,Katz JN,Losina E

    更新日期:2010-01-01 00:00:00

  • Cost-effectiveness analysis of hepatitis B vaccination strategies in Catalonia, Spain.

    abstract::Hepatitis B virus (HBV) infection is an important public health problem all over the world. Vaccination is one way to prevent it, and several strategies can be used depending on endemicity, the main pattern of HBV transmission and the demographic structure of the population. In this study, an economic comparison of 3 ...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/00019053-199507050-00007

    authors: Antoñanzas F,Garuz R,Rovira J,Antón F,Trinxet C,Navas E,Salleras L

    更新日期:1995-05-01 00:00:00

  • A randomised trial of the cost effectiveness of buprenorphine as an alternative to methadone maintenance treatment for heroin dependence in a primary care setting.

    abstract:BACKGROUND AND AIM:Buprenorphine offers an alternative to methadone in the treatment of heroin dependence, and has the advantage of allowing alternate-day dosing. This study is the first to examine the cost effectiveness of buprenorphine as maintenance treatment for heroin dependence in a primary care setting using eco...

    journal_title:PharmacoEconomics

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.2165/00019053-200523010-00007

    authors: Harris AH,Gospodarevskaya E,Ritter AJ

    更新日期:2005-01-01 00:00:00

  • Selective versus nonselective beta adrenoceptor antagonists in hypertension.

    abstract::The application of cost-effectiveness methodology is particularly important in widespread diseases such as hypertension. However, because prospective cost-effectiveness analyses comparing different antihypertensive drugs are not currently available, differences in the cost effectiveness of these drugs can only be esti...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章,评审

    doi:10.2165/00019053-199508060-00006

    authors: Van Bortel LM,Ament AJ

    更新日期:1995-12-01 00:00:00

  • Does economic incentive matter for rational use of medicine? China's experience from the essential medicines program.

    abstract:BACKGROUND:Before the new round of healthcare reform in China, primary healthcare providers could obtain a fixed 15 % or greater mark-up of profits by prescribing and selling medicines. There were concerns that this perverse incentive was a key cause of irrational medicine use. China's new Essential Medicines Program (...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.1007/s40273-013-0068-z

    authors: Chen M,Wang L,Chen W,Zhang L,Jiang H,Mao W

    更新日期:2014-03-01 00:00:00

  • Using health outcomes data to inform decision-making: patient perspective.

    abstract::Increasingly in the developed world, patients expect to be partners in the management of their healthcare. Several recent studies show that the patient perspective differs from the perspective of the healthcare provider. Patients usually focus on the impact of their condition on their lifestyle, while clinicians may t...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/00019053-200119002-00009

    authors: Rameckers E

    更新日期:2001-01-01 00:00:00

  • Personalized Medicine and Pay for Performance: Should Pharmaceutical Firms be Fully Penalized when Treatment Fails?

    abstract::In this article, we model the behavior of a pharmaceutical firm that has marketing authorization for a new therapy believed to be a candidate for personalized use in a subset of patients, but that lacks information as to why a response is seen only in some patients. We characterize the optimal outcome-based reimbursem...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.1007/s40273-018-0619-4

    authors: Antoñanzas F,Rodríguez-Ibeas R,Juárez-Castelló CA

    更新日期:2018-07-01 00:00:00

  • Development of an economic model for the management of upper gastrointestinal disease in primary care. Preliminary findings.

    abstract::Health economic models for identifying therapeutic options that maximise health benefits from limited healthcare resources are being developed in a number of therapeutic areas. The development of such a model for upper gastrointestinal (UGI) symptoms to support decision-making by primary care clinicians is of particul...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章,评审

    doi:10.2165/00019053-199814002-00003

    authors: Haycox A,Butterworth M,Walley T,Barton S

    更新日期:1998-01-01 00:00:00

  • Cost-effectiveness analysis of topical calcipotriol versus short-contact dithranol. In the treatment of mild to moderate plaque psoriasis.

    abstract:OBJECTIVE:To examine the relative cost effectiveness of topical calcipotriol and short-contact dithranol in the treatment of mild to moderate plaque psoriasis. DESIGN AND SETTING:This was a modelling study from the perspective of the UK National Health Service as payer. METHODS:The interventions were compared using 2...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/00019053-200018050-00006

    authors: Ashcroft DM,Li Wan Po A,Williams HC,Griffiths CE

    更新日期:2000-11-01 00:00:00

  • Adherence to guidelines for community-acquired pneumonia: does it decrease cost of care?

    abstract::Community-acquired pneumonia (CAP) is a common diagnosis and care of CAP is responsible for significant healthcare expenditures, the majority of which are for patients who require hospitalisation. Studies have shown that significant variation exists among institutions with respect to antibacterial costs and length of ...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章,评审

    doi:10.2165/00019053-200422070-00001

    authors: Brown PD

    更新日期:2004-01-01 00:00:00

  • Feasibility, Validity and Differences in Adolescent and Adult EQ-5D-Y Health State Valuation in Australia and Spain: An Application of Best-Worst Scaling.

    abstract:BACKGROUND:The measurement and valuation of health-related quality of life for and by young people are increasingly important, yet research on the impact of study perspective and validity of preferences obtained from young populations remains limited. OBJECTIVE:The objective of this study was to evaluate the feasibili...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.1007/s40273-020-00884-9

    authors: Dalziel K,Catchpool M,García-Lorenzo B,Gorostiza I,Norman R,Rivero-Arias O

    更新日期:2020-05-01 00:00:00

  • Onychomycosis: health-related quality of life considerations.

    abstract::The symptoms of onychomycosis and their impact on personal appearance are important determinants of patients' perceptions of their own health. The effect of onychomycosis is greater on psychosocial than physical functioning and is directly related to the extent of nail involvement. This review identified a number of d...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章,评审

    doi:10.2165/00019053-200220010-00003

    authors: Shaw JW,Joish VN,Coons SJ

    更新日期:2002-01-01 00:00:00

  • Translating safety, efficacy and compliance into economic value for controlled release dosage forms.

    abstract::Advanced controlled release (CR) dosage forms are relative newcomers to pharmaceutical markets, and few studies relate their efficacy, safety or compliance benefits to economic value. This literature review was undertaken to assess the cost effectiveness of CR dosage forms using such measures as purchase costs, total ...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章,meta分析

    doi:10.2165/00019053-199405060-00005

    authors: Cramer MP,Saks SR

    更新日期:1994-06-01 00:00:00