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Cost-effectiveness of allopurinol versus febuxostat in the treatment of gout patients: A systematic review

Background: In recent years, increased longevity, poor dietary habits, and the rising prevalence of metabolic syndrome and hypertension have increased the prevalence of gout. Gout significantly increases direct and indirect costs and reduces the quality of life. Allopurinol and febuxostat are the mo...

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Autores principales: Rezapour, Aziz, Alidoost, Saeide, Asgharzadeh, Asra, Farhadi, Zeynab, Khodadadi, Najme, Mohammadi Bakhsh, Roghayeh, Sepehrian, Razieh, Salemi, Morteza, Taheri Mirghaed, Masood, Behzadifar, Masoud, Sohrabi, Rahim
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Iran University of Medical Sciences 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7456432/
https://www.ncbi.nlm.nih.gov/pubmed/32884916
http://dx.doi.org/10.34171/mjiri.34.41
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author Rezapour, Aziz
Alidoost, Saeide
Asgharzadeh, Asra
Farhadi, Zeynab
Khodadadi, Najme
Mohammadi Bakhsh, Roghayeh
Sepehrian, Razieh
Salemi, Morteza
Taheri Mirghaed, Masood
Behzadifar, Masoud
Sohrabi, Rahim
author_facet Rezapour, Aziz
Alidoost, Saeide
Asgharzadeh, Asra
Farhadi, Zeynab
Khodadadi, Najme
Mohammadi Bakhsh, Roghayeh
Sepehrian, Razieh
Salemi, Morteza
Taheri Mirghaed, Masood
Behzadifar, Masoud
Sohrabi, Rahim
author_sort Rezapour, Aziz
collection PubMed
description Background: In recent years, increased longevity, poor dietary habits, and the rising prevalence of metabolic syndrome and hypertension have increased the prevalence of gout. Gout significantly increases direct and indirect costs and reduces the quality of life. Allopurinol and febuxostat are the most commonly used drugs for reducing uric acid levels and controlling this disease with different cost-effectiveness. The present systematic review compares the cost-effectiveness of these drugs. Methods: This was a systematic review of economic evaluations. Cochrane CENTRAL, Web of Science, PubMed, Embase, and the Cost-Effectiveness Analysis (CEA) Registry were searched up to April 30, 2018, based on the specific search strategy of each database. Keywords used in the search include gout, cost-effectiveness, allopurinol, and febuxostat in MeSH and free-text forms. Screening of identified studies, data extraction, and quality assessment were done independently by 2 reviewers. The quality of studies was assessed based on Drummond Checklist. Finally, a qualitative analysis was done to analyze the results. Results: A total of 94 studies were identified through database search and the review of references. After screening the titles, abstracts, and full-texts, 6 economic evaluations were included in the review. The majority of the studies had been conducted in the US using the Markov model, within a 5-year horizon, and from the payer’s perspective, with the quality of life as a measure of effectiveness. In most studies, the incremental cost-effectiveness ratios (ICERs) of febuxostat per quality-adjusted life year (QALY) were below the threshold (10 000$/QALY and 30 000€/QALY). Conclusion: Febuxostat has been shown to be more cost-effective than allopurinol in all treatment sequences in studies that have used uric acid levels as the measure of effectiveness. Furthermore, in studies with the quality of life as the measure of effectiveness, febuxostat has been shown to be very cost-effective as the second-line treatment.
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spelling pubmed-74564322020-09-02 Cost-effectiveness of allopurinol versus febuxostat in the treatment of gout patients: A systematic review Rezapour, Aziz Alidoost, Saeide Asgharzadeh, Asra Farhadi, Zeynab Khodadadi, Najme Mohammadi Bakhsh, Roghayeh Sepehrian, Razieh Salemi, Morteza Taheri Mirghaed, Masood Behzadifar, Masoud Sohrabi, Rahim Med J Islam Repub Iran Review Article Background: In recent years, increased longevity, poor dietary habits, and the rising prevalence of metabolic syndrome and hypertension have increased the prevalence of gout. Gout significantly increases direct and indirect costs and reduces the quality of life. Allopurinol and febuxostat are the most commonly used drugs for reducing uric acid levels and controlling this disease with different cost-effectiveness. The present systematic review compares the cost-effectiveness of these drugs. Methods: This was a systematic review of economic evaluations. Cochrane CENTRAL, Web of Science, PubMed, Embase, and the Cost-Effectiveness Analysis (CEA) Registry were searched up to April 30, 2018, based on the specific search strategy of each database. Keywords used in the search include gout, cost-effectiveness, allopurinol, and febuxostat in MeSH and free-text forms. Screening of identified studies, data extraction, and quality assessment were done independently by 2 reviewers. The quality of studies was assessed based on Drummond Checklist. Finally, a qualitative analysis was done to analyze the results. Results: A total of 94 studies were identified through database search and the review of references. After screening the titles, abstracts, and full-texts, 6 economic evaluations were included in the review. The majority of the studies had been conducted in the US using the Markov model, within a 5-year horizon, and from the payer’s perspective, with the quality of life as a measure of effectiveness. In most studies, the incremental cost-effectiveness ratios (ICERs) of febuxostat per quality-adjusted life year (QALY) were below the threshold (10 000$/QALY and 30 000€/QALY). Conclusion: Febuxostat has been shown to be more cost-effective than allopurinol in all treatment sequences in studies that have used uric acid levels as the measure of effectiveness. Furthermore, in studies with the quality of life as the measure of effectiveness, febuxostat has been shown to be very cost-effective as the second-line treatment. Iran University of Medical Sciences 2020-04-30 /pmc/articles/PMC7456432/ /pubmed/32884916 http://dx.doi.org/10.34171/mjiri.34.41 Text en © 2020 Iran University of Medical Sciences http://creativecommons.org/licenses/by-nc-sa/1.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution NonCommercial-ShareAlike 1.0 License (CC BY-NC-SA 1.0), which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.
spellingShingle Review Article
Rezapour, Aziz
Alidoost, Saeide
Asgharzadeh, Asra
Farhadi, Zeynab
Khodadadi, Najme
Mohammadi Bakhsh, Roghayeh
Sepehrian, Razieh
Salemi, Morteza
Taheri Mirghaed, Masood
Behzadifar, Masoud
Sohrabi, Rahim
Cost-effectiveness of allopurinol versus febuxostat in the treatment of gout patients: A systematic review
title Cost-effectiveness of allopurinol versus febuxostat in the treatment of gout patients: A systematic review
title_full Cost-effectiveness of allopurinol versus febuxostat in the treatment of gout patients: A systematic review
title_fullStr Cost-effectiveness of allopurinol versus febuxostat in the treatment of gout patients: A systematic review
title_full_unstemmed Cost-effectiveness of allopurinol versus febuxostat in the treatment of gout patients: A systematic review
title_short Cost-effectiveness of allopurinol versus febuxostat in the treatment of gout patients: A systematic review
title_sort cost-effectiveness of allopurinol versus febuxostat in the treatment of gout patients: a systematic review
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7456432/
https://www.ncbi.nlm.nih.gov/pubmed/32884916
http://dx.doi.org/10.34171/mjiri.34.41
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