Cost-effectiveness analysis of preoperative treatment of acromegaly with somatostatin analogue on surgical outcome

Margusino‐Framiñán, Luis; Pértega-Díaz, Sonia; Pena-Bello, Lara; Sangiao‐Alvarellos, Susana; Outeiriño-Blanco, Elena; Pita-Gutiérrez, Francisco; Pita-Fernández, Salvador; Cordido, Fernando

doi:10.1016/j.ejim.2015.07.019

Cited by 15 publications

(10 citation statements)

References 52 publications

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“…In an analysis by Biermasz et al the cost of SSA therapy in the Netherlands was presented at EUR 16,500 for octreotide LAR (with average dose of 24 mg/4 weeks) and EUR 23,000 for lanreotide Autogel (average dose of 103 mg/4 weeks) [14]. Margusino-Framiñán et al estimated that mean cost of one year of postoperative treatment for a patient not cured after surgery was around EUR 13,150 [21].…”

Section: Somatostatin Analoguesmentioning

confidence: 99%

“…Precisely, yearly costs were reported as EUR 28,300-84,900 per patient for pegvisomant compared to EUR 7900-19,800 for SSA, depending on the dose of both used drugs [14]. In comparison, the mean annual cost of pegvisomant treatment in Spain was EUR 37,600 and in the USA USD 101,800 [21,28].…”

Section: Pegvisomantmentioning

confidence: 99%

“…Margusino-Framiñán i wsp. oszacowali, że średni koszt leczenia pooperacyjnego przez 1 rok u nieskutecznie zoperowanego pacjenta wynosił około 13 150 euro [21].…”

Section: Prace Poglądoweunclassified

“…Na koniec drugiej fazy badania u 94 spośród 124 pacjentów zachowano 6-lub 8-tygodniowe odstępy między iniekcjami przy prawidłowym stężeniu IGF-1 [22]. W badaniu Biermasz [21]. W przypadku stosowania preparatu lanreotydu w postaci roztworu do wstrzykiwań (Somatuline Autogel) możliwe jest samodzielne podawanie leku.…”

Section: Prace Poglądoweunclassified

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The real costs of acromegaly: analysis of different therapies

Elbaum

Mizera

Bolanowski

2019

Endokrynologia Polska

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Acromegaly is a rare, chronic condition caused by growth hormone (GH) overproduction, usually due to a benign tumour of the pituitary gland. During the disease many complications occur, including cardiovascular disease and changes in the musculoskeletal, respiratory, and endocrine systems. Treatment includes surgery, medical therapy, and radiation. In this paper a literature review was conducted for information related to costs of management of acromegaly and its associated comorbidities using PubMed. The majority of total costs represent pharmacological treatment, especially the most common somatostatin analogues (SSA) therapy. The average reported annual cost of SSA therapy is EUR 12,000-40,000. Surgery reduces the cost of care via the possibility of avoiding lifelong pharmacological treatment. Radiotherapy is also suggested to lower the costs of therapy because about 60% of patients eventually will not require further pharmacological treatment; however, it is connected with negative outcomes like hypopituitarism, lower quality of life, and increased mortality. Cabergoline and pegvisomant are the lowest and highest priced treatments, respectively, but the overall impact on the cost of therapy is minor due to less frequent usage of these drugs. It is hard to fully estimate the impact of comorbidities of acromegaly on financial burden because patients are treated for them many years before the diagnosis of the underlying pathology. The treatment cost of comorbidities is higher in uncontrolled patients. Life-long treatment of acromegaly and its comorbidities is very expensive. Early diagnosis and successful treatment reduce direct and indirect costs. (Endokrynol Pol 2019; 70 (1): 74-79)

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Section: Somatostatin Analoguesmentioning

confidence: 99%

Section: Pegvisomantmentioning

confidence: 99%

“…Margusino-Framiñán i wsp. oszacowali, że średni koszt leczenia pooperacyjnego przez 1 rok u nieskutecznie zoperowanego pacjenta wynosił około 13 150 euro [21].…”

Section: Prace Poglądoweunclassified

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The real costs of acromegaly: analysis of different therapies

Elbaum

Mizera

Bolanowski

2019

Endokrynologia Polska

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“…Moreover, pre-and postoperative medical treatment should be considered, in order to secure long-term postoperative normality of GH levels and action in target tissues (1,10), with the aim to improve morbidity and mortality for a debilitating disease but also reduce the need for complicated and costly long-term medical therapy. Although, cure by surgery is obviously the most cost-effective treatment, newer studies have shown that preoperative SRLs treatment of macroadenomas not only achieves a significant improvement of the surgical outcomes, but seems also to be cost-effective (11,12).…”

Section: Introductionmentioning

confidence: 99%

MANAGEMENT OF ENDOCRINE DISEASE: Individualised management of acromegaly

Bollerslev

Heck

Olarescu

2019

European Journal of Endocrinology

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Acromegaly is a rare and challenging disease calling for management in highly specialised multidisciplinary teams (MDTs). Untreated disease has severe morbidity and a clearly increased mortality. Major attainments have been gained over the latest decades, and therefore, the aim of this review is to discuss recent achievements in modern multimodal therapy of acromegaly performed by MDTs, with an emphasis on an individualised, proactive management from the time of diagnosis to long-term outcome. Treatment by surgery is the only potential curative treatment, however, even with modern techniques still with modest cure rates, leaving the patients to often long-term medical treatment. Treatment strategies have changed dramatically in the Western world over recent years, implying a more proactive treatment algorithm often with a shorter or longer pre-surgical treatment period with somatostatin receptor ligands (SRLs). Not all patients will however respond to primary treatment with conventional SRLs and there has recently been a development of potential biomarkers for response that has been implemented in the clinical routine. By today, multimodal treatment can bring every patient in remission, but still almost a third of all patients are undertreated according to large, international registries. On the other hand, it might be a challenge not to over treat thereby bringing the patient into a state of relative or absolute growth hormone deficiency. Clinical series published during the last decade on treatment of patients with acromegaly have indicated a normalisation of mortality, most probably reflecting the proactive and individualised modern treatment. In conclusion, modern, multimodal treatment seems to have normalised mortality, but still the patients suffer from a high multi-organ morbidity and often multipharmacy. Every patient should receive an individualised, proactive treatment in order to improve long-term outcome and to reduce costs for the society.Correspondence should be addressed to J Bollerslev . His special interest is within clinical and translational endocrinology, and in particular, in classical endocrine diseases, such as acromegaly and Cushing's, often studying bone as target tissues for clinical activity. A major topic has been clinical management of acromegaly, and especially searching for biomarkers for responsiveness to medical therapy. Prospectively collected data of newly diagnosed patients with acromegaly has been the background for current studies of individualised, multimodal and transdisciplinary treatment. European Journal of Endocrinology 181:2 R60 Review J Bollerslev and others Managing acromegaly https://eje.bioscientifica.com European Journal of Endocrinology 181:2 R61 Review J Bollerslev and others Managing acromegaly https://eje.bioscientifica.com European Journal of Endocrinology 181:2 R63 Review J Bollerslev and others Managing acromegaly https://eje.bioscientifica.com European Journal of Endocrinology 181:2 R64 Review J Bollerslev and others Managing acromegaly https://eje.bioscie...

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