2013, Número 6
Rev Mex Neuroci 2013; 14 (6)
Evaluación económica del uso de rasagilina en etapas tempranas de la enfermedad de Parkinson desde la perspectiva del Instituto Mexicano del Seguro Social
Pizarro CM, Rizzoli CA, Salmerón GG, Cervantes CMA, Soto MH
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Idioma: Español
Referencias bibliográficas: 20
Paginas: 321-327
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RESUMEN
Introducciòn: Parkinson’s disease (PD) is a neurodegenerative disorder with an estimated incidence of 40-50 cases per 100,000 inhabitants per year. Inhibitors of the enzyme monoamine oxidase B have neuroprotective properties that benefit patients in the early stages of the disease.Objetivo: To perform a cost-effectiveness and a cost-utility evaluation of rasagiline in the treatment of early PD in comparison with pramipexol.
Metodos: We performed a cost-effectiveness and cost-utility analysis to compare rasagiline and pramipexole in the early treatment of early PD using a Markov model, from the perspective of the health sector in Mexico. The Markov model had a time horizon of five years, with semiannual cycles. An analysis of deterministic sensitivity (change in the price of rasagiline, change in daily doses of pramipexole, discount rate, changes in quality-adjusted life years, QALY) and Monte Carlo simulations to determine the robustness of the model.
Resultados: The total cost of rasagiline treatment (start, tracing to 5 years and treating dyskinesia) was $ 190,646.45, and of pramipexole $183, 822.60. However, the gain in QALYs for patients with early-stage PD was 3.70 for patients treated with rasagiline and 3.50 for those treated with pramipexole. The cost per QALY is $ 33,400.00, which is less than one per capita gross product of Mexico.
Conclusiones: From the perspective of the Mexican public health sector, the use of rasagiline could imply greater gains in QALYs, at an acceptable cost, compared with the use of pramipexole in the early treatment of PD.
REFERENCIAS (EN ESTE ARTÍCULO)
Rascol O, Brooks DJ, Melamed E, Oertel W, Poewe W, Stocci F, et al. Rasagiline as an adjunct to levodopa in patients with Parkinson’s disease and motor fluctuations (LARGO, Lasting effecto in adjunct therapy with Rasagiline Given Once daily, study): a randomized, double blind, parallel-group trial. Lancet 2005; 365: 947-54.