The available evidence on the cost-effectiveness of somatropin is rather limited. Cost-effectiveness data have been mostly estimated in those countries (e.g. England, through the NICE - National Institute for Health and Care Excellence) where they are used to issue recommendations on new (and already existing) drugs. The available data show that somatropin is cost-effective compared with the no-treatment option, i.e. the ICER is below the existing thresholds (£ 20k-30k per quality-adjusted life years saved) for growth hormone deficiency. For other indications the evidence is more controversial. However, the Appraisal Committee of NICE has recommended somatropin for all indications considering (i) the uncertainty over patients quality of life and (ii) the high variability of actual prices paid by the National Health Service. According to the Committee, the choice of product should be made on an individual basis, taking into consideration the likelihood of adherence to treatment and, in the case more than one product is suitable, considering the least costly product. These data may suggest that evidence should be collected on differences among products (including differences in patients adherence) and, should this evidence be not robust, competition on the off-patent market should be enhanced to promote allocative efficiency.
La valutazione economica della terapia con ormone della crescita
JOMMI, CLAUDIO
2013
Abstract
The available evidence on the cost-effectiveness of somatropin is rather limited. Cost-effectiveness data have been mostly estimated in those countries (e.g. England, through the NICE - National Institute for Health and Care Excellence) where they are used to issue recommendations on new (and already existing) drugs. The available data show that somatropin is cost-effective compared with the no-treatment option, i.e. the ICER is below the existing thresholds (£ 20k-30k per quality-adjusted life years saved) for growth hormone deficiency. For other indications the evidence is more controversial. However, the Appraisal Committee of NICE has recommended somatropin for all indications considering (i) the uncertainty over patients quality of life and (ii) the high variability of actual prices paid by the National Health Service. According to the Committee, the choice of product should be made on an individual basis, taking into consideration the likelihood of adherence to treatment and, in the case more than one product is suitable, considering the least costly product. These data may suggest that evidence should be collected on differences among products (including differences in patients adherence) and, should this evidence be not robust, competition on the off-patent market should be enhanced to promote allocative efficiency.
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