Cost-utility analysis of MMX mesalazine compared with mesalazine in the treatment of mild-to-moderate ulcerative colitis under brazilian Public Health Care perspective

Abstract

Objectives: To perform a cost-utility analysis of MMX mesalazine (Mesacol® MMX) versus conventional mesalazine for the ulcerative colitis (UC) treatment under Brazilian public health care perspective. Methods: The study was a cost-utility analysis based on a 5-year or lifetime Markov modeling. Epidemiological and efficacy data derived from a critical appraisal of the scientific literature. The potential effect of dosing frequency on adherence and possible long-term effects of remission maintenance on colorectal cancer (CRC) rates were also investigated. Only direct medical costs were considered. Costs and benefits were discounted at 5% yearly. Outcomes were expressed as quality adjusted life years (QALY). Probability sensitivity analysis (PSA) was conducted to assess model robustness. Results: The economic analysis suggests that MMX mesalazine treatment is likely to generate gains when compared with mesalazina (5-year: 0.0130 QALYs/patient / Lifetime: 0.0458 QALYs/patient). In economics terms, MMX mesalazine has incremental cost of -39.414BRL in comparison with Pentasa®, during lifetime. Effects of remission maintenance on CRC rates suggest an incremental benefit of MMX mesalazine over mesalazine even better (Life-time: 0.0680 QALYs/patient). This analysis suggests that MMX mesalazine is cost-saving compared with conventional mesalazina (Pentasa®). Conclusion: Our study demonstrates that advantages in adherence to treatment with MMX mesalazine suggested an effect in quality of life with lower cost being cost-saving for UC treatment compared with conventional mesalazina (Pentasa®).