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Colegio de Medicina Interna de México.

2020, Number 5

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Med Int Mex 2020; 36 (5)

Rifaximin-α in hepatic encephalopathy. Pharmaco-economic considerations for Mexico

Frati-Munari R, Galindo-Suárez M

Language: Spanish
References: 56
Page: 621-632
PDF size: 266.01 Kb.


ABSTRACT

Background: Hepatic encephalopathy is a serious manifestation of hepatic disease which can lead to death. Several drugs are prescribed in its treatment. Rifaximin-α (RFX) has been used successfully in the treatment of open hepatic encephalopathy, in the prevention of recurrent hepatic encephalopathy and in minimal hepatic encephalopathy.
Objective: To perform a shallow analysis of the costs of the treatment of hepatic encephalopathy with Mexican prices.
Material and Method: A retrospective study was done with the published data on efficacy, maximal public price of rifaximin-α, neomycin, lactulose, L-ornithine L-aspartate, and the hospital costs of Mexican Institute of Social Security published for the year 2018, a cost minimization analysis, the cost for an episode of open hepatic encephalopathy and for prevention of recurrence of hepatic encephalopathy were calculated.
Results: Considering similar therapeutic efficacy, the cost minimization analysis showed that the treatment with rifaximin was cost saving compared with therapeutic alternatives. In overt hepatic encephalopathy the combination of rifaximin with lactulose, that has been considered the most effective approach, resulted cost-effective due to shorter hospitalization. The cost of one-year continuous treatment to prevent recurrence of hepatic encephalopathy was 64,330 Mexican pesos per patient with rifaximin and 172,012 Mexican pesos with lactulose.
Conclusions: Rifaximin-α is a dominant alternative of treatment of open hepatic encephalopathy and for the prevention of hepatic encephalopathy recurrence.


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