4.1 Article

Cost-utility of ambrisentan and bosentan for pediatric pulmonary arterial hypertension

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TAYLOR & FRANCIS LTD
DOI: 10.1080/14737167.2023.2233698

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health economics; public health; healthcare; Colombia; bosentan; ambrisentan

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This study aims to assess the cost-utility of bosentan compared to ambrisentan in the treatment of pediatric patients with pulmonary arterial hypertension. The results indicate that bosentan is more cost-effective than ambrisentan in this context.
IntroductionDespite the increasing evidence supporting the efficacy of ambrisentan and bosentan in improving functional classes among pediatric patients with pulmonary arterial hypertension (PAH), there is a lack of information regarding their cost implications. Therefore, the objective of this study is to assess the cost-utility of bosentan compared to ambrisentan for the treatment of pediatric patients with PAH in Colombia.MethodsWe employed a Markov model to estimate the costs and quality-adjusted life-years (QALYs) associated with the use of ambrisentan or bosentan in pediatric patients diagnosed with pulmonary arterial hypertension (PAH). To ensure the reliability of our findings, we conducted sensitivity analyses to assess the robustness of the model. In our cost-effectiveness analysis, we evaluated the outcomes at a willingness-to-pay (WTP) threshold of US$5,180.ResultsThe expected annual cost per patient receiving ambrisentan was estimated to be $16,055 (95% CI 15,937 -16,172), while for bosentan it was $14,503 (95% CI 14,489 -14,615). The QALYs per person estimated for ambrisentan were 0.39 (95% CI 0.381-0.382), whereas for bosentan it was 0.40 (95% CI 0.401-0.403).ConclusionOur economic evaluation shows that ambrisentan is not cost-effective regarding bosentan to in treating pulmonary arterial hypertension in C.

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