PMID- 27113227
OWN - NLM
STAT- MEDLINE
DCOM- 20161230
LR  - 20181202
IS  - 1179-1918 (Electronic)
IS  - 1173-2563 (Linking)
VI  - 36
IP  - 7
DP  - 2016 Jul
TI  - Economic Evaluation of Intravenous Immunoglobulin plus Corticosteroids for the 
      Treatment of Steroid-Resistant Chronic Inflammatory Demyelinating 
      Polyradiculoneuropathy in Thailand.
PG  - 557-66
LID - 10.1007/s40261-016-0401-3 [doi]
AB  - BACKGROUND AND OBJECTIVE: Intravenous immunoglobulin (IVIG) has been recommended 
      for steroid-resistant chronic inflammatory demyelinating polyradiculoneuropathy 
      (CIDP). The treatment, however, is very costly to healthcare system, and there 
      remains no evidence of its economic justifiability. This study aimed to conduct 
      an economic evaluation (EE) of IVIG plus corticosteroids in steroid-resistant 
      CIDP in Thailand. METHODS: A Markov model was constructed to estimate the 
      lifetime costs and outcomes for IVIG plus corticosteroids in comparison with 
      immunosuppressants plus corticosteroids in steroid-resistant CIDP patients from a 
      societal perspective. Efficacy and utility data were obtained from clinical 
      literature, meta-analyses, medical record reviews, and patient interviews. Cost 
      data were obtained from list prices, an electronic hospital database, published 
      source, and patient interviews. All costs [in 2015 US dollars (US$)] and outcomes 
      were discounted at 3 % annually. One-way and probabilistic sensitivity analyses 
      were conducted. RESULTS: In the base-case, the incremental costs and 
      quality-adjusted life years (QALYs) of IVIG plus corticosteroids versus 
      immunosuppressants plus corticosteroids were US$2112.02 and 1.263 QALYs, 
      respectively, resulting in an incremental cost-effectiveness ratio (ICER) of 
      US$1672.71 per QALY gained. Sensitivity analyses revealed that the utility value 
      of disabled patients was the greatest influence on ICER. At a societal 
      willingness-to-pay threshold in Thailand of US$4672 per QALY gained, IVIG plus 
      corticosteroids had a 92.1 % probability of being cost effective. CONCLUSIONS: At 
      a threshold of US$4672 per QALY gained, IVIG plus corticosteroids is considered a 
      cost-effective treatment for steroid-resistant CIDP patients in Thailand.
FAU - Bamrungsawad, Naruemon
AU  - Bamrungsawad N
AD  - Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan 
      University, Phitsanulok, Thailand.
FAU - Upakdee, Nilawan
AU  - Upakdee N
AD  - Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan 
      University, Phitsanulok, Thailand.
FAU - Pratoomsoot, Chayanin
AU  - Pratoomsoot C
AD  - Faculty of Public Health, Naresuan University, Phitsanulok, Thailand.
FAU - Sruamsiri, Rosarin
AU  - Sruamsiri R
AD  - Center of Pharmaceutical Outcomes Research, Department of Pharmacy Practice, 
      Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand.
FAU - Dilokthornsakul, Piyameth
AU  - Dilokthornsakul P
AD  - Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan 
      University, Phitsanulok, Thailand.
AD  - Center of Pharmaceutical Outcomes Research, Department of Pharmacy Practice, 
      Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand.
FAU - Dechanont, Supinya
AU  - Dechanont S
AD  - Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan 
      University, Phitsanulok, Thailand.
FAU - Wu, David Bin-Chia
AU  - Wu DB
AD  - School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, 46150, 
      Bandar Sunway, Selangor, Malaysia.
FAU - Dejthevaporn, Charungthai
AU  - Dejthevaporn C
AD  - Division of Neurology, Department of Medicine, Faculty of Medicine, Ramathibodi 
      Hospital, Mahidol University, Bangkok, Thailand.
FAU - Chaiyakunapruk, Nathorn
AU  - Chaiyakunapruk N
AD  - Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan 
      University, Phitsanulok, Thailand. nathorn.chaiyakunapruk@monash.edu.
AD  - Center of Pharmaceutical Outcomes Research, Department of Pharmacy Practice, 
      Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand. 
      nathorn.chaiyakunapruk@monash.edu.
AD  - School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, 46150, 
      Bandar Sunway, Selangor, Malaysia. nathorn.chaiyakunapruk@monash.edu.
AD  - School of Population Health, University of Queensland, Brisbane, Australia. 
      nathorn.chaiyakunapruk@monash.edu.
AD  - School of Pharmacy, University of Wisconsin-Madison, Madison, WI, USA. 
      nathorn.chaiyakunapruk@monash.edu.
LA  - eng
PT  - Journal Article
PL  - New Zealand
TA  - Clin Drug Investig
JT  - Clinical drug investigation
JID - 9504817
RN  - 0 (Adrenal Cortex Hormones)
RN  - 0 (Immunoglobulins, Intravenous)
RN  - 0 (Immunosuppressive Agents)
RN  - 0 (Steroids)
SB  - IM
MH  - Adrenal Cortex Hormones/*economics/*therapeutic use
MH  - Adult
MH  - Aged
MH  - Cost-Benefit Analysis
MH  - Databases, Factual
MH  - Disability Evaluation
MH  - Disease Progression
MH  - Drug Costs
MH  - Drug Resistance
MH  - Female
MH  - Humans
MH  - Immunoglobulins, Intravenous/*economics/*therapeutic use
MH  - Immunosuppressive Agents/economics/therapeutic use
MH  - Male
MH  - Markov Chains
MH  - Middle Aged
MH  - Models, Economic
MH  - Polyradiculoneuropathy, Chronic Inflammatory Demyelinating/*drug 
      therapy/*economics
MH  - Quality-Adjusted Life Years
MH  - Steroids/therapeutic use
MH  - Thailand
EDAT- 2016/04/27 06:00
MHDA- 2016/12/31 06:00
CRDT- 2016/04/27 06:00
PHST- 2016/04/27 06:00 [entrez]
PHST- 2016/04/27 06:00 [pubmed]
PHST- 2016/12/31 06:00 [medline]
AID - 10.1007/s40261-016-0401-3 [pii]
AID - 10.1007/s40261-016-0401-3 [doi]
PST - ppublish
SO  - Clin Drug Investig. 2016 Jul;36(7):557-66. doi: 10.1007/s40261-016-0401-3.