Cost Effectiveness of Using Terlipressin to Treat Hepatorenal Syndrome

FERREIRA, Luciana Marcondes; Ferreira, Caroline Marcondes; Mazo, Daniel Ferraz de Campos; Haddad, Luciana Bertocco de Paiva

doi:10.1590/s0004-2803.202202000-48

Cited by 4 publications

(4 citation statements)

References 26 publications

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“…A meta-analysis study showed that the treatment strategy using terlipressin was more economical vs. noradrenaline from the perspectives of the Brazilian public health system and private health insurance [ 42 ]. Further, a cost-effectiveness study showed that terlipressin + albumin is cost-effective compared to norepinephrine + albumin administered to patients who were diagnosed with type 1 HRS in a controlled environment from a Brazilian public single-payer healthcare system [ 43 ].…”

Section: Discussionmentioning

confidence: 99%

Treatment-Related Cost Analysis of Terlipressin for Adults with Hepatorenal Syndrome with Rapid Reduction in Kidney Function

Huang,

Bindra,

Chopra

et al. 2023

Adv Ther

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Introduction Hepatorenal syndrome (HRS), a special form of acute kidney failure, is a rare, acute, life-threatening complication of cirrhosis and has a very poor prognosis. Terlipressin (TERLIVAZ ® ) is the first and only pharmacological treatment approved by Food and Drug Administration (September 2022) to improve kidney function for adults with HRS with rapid reduction in kidney function. We constructed a decision analytic economic model to estimate the cost per complete response/HRS reversal of terlipressin + albumin from a United States hospital perspective. Methods A decision analytic model was developed to estimate the HRS treatment-related cost per response over an HRS hospitalization (assuming 14 days). Patients can experience either HRS reversal (complete response) or no HRS reversal (partial/no response) upon receipt of treatment. The efficacy, safety, and treatment duration data were from published head-to-head randomized international trials. Total treatment cost comprised drug acquisition and treatment-related costs (intensive care unit [ICU], dialysis [intermittent or continuous], pulse oximetry monitoring for terlipressin, and adverse events) sourced from the published literature. Cost per response, defined as the total treatment cost per HRS reversal was estimated for each treatment. The number needed to treat (NNT), defined as the number of patients treated to achieve HRS reversal in 1 additional patient, was estimated. Results Cost per response of terlipressin + albumin was lower than midodrine and octreotide + albumin (M&O) (US$85,315 vs. $467,794) and norepinephrine + albumin ($81,614 vs. $139,324). NNT for HRS reversal was 2 patients with terlipressin + albumin vs. M&O + albumin and 4 patients with terlipressin + albumin vs. norepinephrine + albumin, respectively. Conclusions The analysis shows that terlipressin is a cost-effective treatment due to its higher efficacy and administration in the non-ICU setting. Terlipressin is a value-based treatment option for appropriate adults with HRS with rapid reduction in kidney function. Supplementary Information The online version contains supplementary material available at 10.1007/s12325-023-02674-z.

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Section: Discussionmentioning

confidence: 99%

Treatment-Related Cost Analysis of Terlipressin for Adults with Hepatorenal Syndrome with Rapid Reduction in Kidney Function

Huang,

Bindra,

Chopra

et al. 2023

Adv Ther

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“…13 A cost effectiveness analysis using data from a university medical center in Brazil determined that terlipressin in combination with albumin for the treatment of hepatorenal syndrome is cost-effective compared with norepinephrine in combination with albumin. 14 Limitations: The study was powered for several outcomes, but not for survival. Follow-up was limited to 90 days.…”

Section: |mentioning

confidence: 99%

Formulary Drug Reviews: Terlipressin

Baker

2023

Hosp Pharm

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Each month, subscribers to The Formulary Monograph Service receive 5 to 6 well-documented monographs on drugs that are newly released or are in late phase 3 trials. The monographs are targeted to Pharmacy & Therapeutics Committees. Subscribers also receive monthly 1-page summary monographs on agents that are useful for agendas and pharmacy/nursing in-services. A comprehensive target drug utilization evaluation/medication use evaluation (DUE/MUE) is also provided each month. With a subscription, the monographs are available online to subscribers. Monographs can be customized to meet the needs of a facility. Through the cooperation of The Formulary, Hospital Pharmacy publishes selected reviews in this column. For more information about The Formulary Monograph Service, contact Wolters Kluwer customer service at 866-397-3433.

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“…Os especialistas sugerem que a resposta à terlipressina deve ser avaliada no dia 4, com Continuação, se a creatinina estiver inferior à linha de base, até que a creatinina seja ≤1,5 mg/dL por 48 horas ou por um total de 14 dias. Em pacientes que não respondem à terlipressina, deve-se considerar imediatamente o transplante de fígado (FERREIRA LM, et al, 2022).…”

Section: Prevenção E Manejo Da Condiçãounclassified

Uma análise da síndrome hepatorrenal

Corrêa,

Barros,

Leite

et al. 2023

Acervo Médico

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Objetivo: Analisar as características da Síndrome Hepatorrenal (SHR). Revisão bibliográfica: A SHR é definida como uma deterioração da função renal que ocorre no contexto de doenças hepáticas crônicas graves, como cirrose avançada ou insuficiência hepática aguda. Se caracteriza por diminuição na perfusão renal devido a uma redução severa do volume circulante efetivo e ativação maciça do sistema endógeno vasoativo que causa vasoconstrição renal no contexto de vasodilatação arterial sistêmica e esplâncnica. O comprometimento renal agudo ocorre em cerca de 27% a 53% dos pacientes internados no hospital com cirrose descompensada e ascite. Considerações finais: A SHR é uma condição grave e potencialmente fatal em pacientes com cirrose hepática. Seu rápido reconhecimento é fundamental. O manejo inclui remover e tratar os precipitantes a fim de mitigar os danos. Além disso, o uso de albumina é fundamental, podendo-se utilizar, também agentes vasoconstritores como a terlipressina. O tratamento definitivo da condição é o transplante hepático, entretanto este nem sempre está prontamente disponível e nem todos os pacientes atendem às condições necessárias para realizá-lo.

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Cost Effectiveness of Using Terlipressin to Treat Hepatorenal Syndrome

Cited by 4 publications

References 26 publications

Treatment-Related Cost Analysis of Terlipressin for Adults with Hepatorenal Syndrome with Rapid Reduction in Kidney Function

Treatment-Related Cost Analysis of Terlipressin for Adults with Hepatorenal Syndrome with Rapid Reduction in Kidney Function

Formulary Drug Reviews: Terlipressin

Uma análise da síndrome hepatorrenal

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