Cost-utility Analysis of Dornase alfa in comparison with Tobramycin for Managing Iranian Patients with Cystic Fibrosis

Abstract

Background: Cystic fibrosis (CF) is a progressive, life-threatening, and autosomal disease, which is most prevalent in Europe, North America, and Australia. This genetic disorder does not have a curative treatment, and current medications to manage CF including Tobramycin, are associated with high economic costs to the healthcare system, and noticeable out-of-pocket and time costs to patients and their families. Dornase alfa, is a recombinant human DNAse, and is an advanced therapeutic intervention. It has been indicated in clinical trials that Dornase alfa elevates FEV1 in CF patients, and enhances lung function. Therefore, this study was designed to evaluate the cost-utility of Dornase alfa compared with Tobramycin in the management of CF patients’ symptoms. Methods: A Markov model was developed based on previous similar studies to determine the cost-utility of Dornase alfa in comparison with Tobramycin. The time horizon of the model and the length of the cycles were assumed 10 years and 28 days, respectively. Results: Based on the cost-utility analysis, from the health system's perspective, Dornase alfa indicated 0.174 higher effectiveness in patients’ QALY than Tobramycin, and resulted in 27,517,260 Rials reduction in costs in the time horizon of 10 years. Conclusion: It is concluded that Dornase alfa could be considered as a cost-effective strategy in the treatment of CF patients associated with increased benefits compared to Tobramycin.

Keywords

• Cystic Fibrosis
• Dornase alfa
• Tobramycin
• Economic evaluation