[Cost-effectiveness assessment through theoretical cost-minimization analysis of the use of two gastro-resistant modified-release mesalazine formulations in the management of ulcerative colitis in Spain]

Abstract

Introduction: The prevalence of ulcerative colitis (UC) and its associated economic burden is increasing in Spain. Oral mesalazines, which are the recommended first-line treatment for mild-moderate UC, show considerable variability in their formulations and prices.

Objective: To carry out a cost-effectiveness assessment of the use of the two formulations of oral gastro-resistant modified-release mesalazine formulations marketed in Spain (Salofalk(®) and Mezavant(®)) for the phases of induction of remission and its maintenance.

Methods: We adapted internationally validated economic models for the management of UC to the Spanish setting. The adaptation focused on the use of oral gastro-resistant modified-release mesalazines. We conducted cost minimization analyses of remission induction (decision tree) and remission maintenance (Markov model).

Results: For the remission induction, Salofalk(®) 3 g/day was superior to (same effectiveness at lower costs) Mezavant(®) 3.6 g/day and 4.8 g/day in any treatment strategy that included oral gastro-resistant modified-release mesalazines. When compared with Mezavant(®) 2.4 g/day, Salofalk(®) was the most cost-effective option. For remission maintenance, all treatment strategies using Salofalk(®) were the most cost-effective option in all the scenarios considered.

Conclusion: Because of the lower cost per gram of Salofalk(®), any treatment strategy based on this drug is more cost-effective than Mezavant(®) for the treatment of mild-moderate UC, whether for the induction of remission or for its maintenance.

Keywords: 5-ASA; Análisis de costes; Colitis ulcerosa; Cost analysis; Enfermedad inflamatoria intestinal; Inflammatory bowel disease; Mesalazina; Mesalazine; Ulcerative colitis.