Cost-utility Analysis of Dornase alfa in comparison with Tobramycin for Managing Iranian Patients with Cystic Fibrosis

Abstract

Background: Cystic fibrosis (CF) is a progressive, life-threatening, and autosomal disease most prevalent in Europe, North America, and Australia. This genetic disorder does not have curative treatment. Current medications to manage CF, including Tobramycin, are associated with high economic costs to the healthcare system and noticeable out-of-pocket and time costs to patients and their families. Dornase alfa is a recombinant human DNAse and is an advanced therapeutic intervention. It has been indicated in clinical trials that Dornase alfa elevates FEV1 in CF patients and enhances lung function. Therefore, this study was designed to evaluate the cost-utility of Dornase alfa compared with Tobramycin in managing CF patients' symptoms.

Methods: A Markov model was developed based on previous similar studies to determine the cost-utility of Dornase alfa in comparison with Tobramycin. The model's time horizon and the cycles' length were assumed to be ten years and 28 days, respectively.

Results: Based on the cost-utility analysis, from the health system's perspective, Dornase alfa indicated 0.174 higher effectiveness in patients' QALY than Tobramycin and resulted in 27,517,260 Rials reduction in costs in the time horizon of 10 years.

Conclusion: Dornase alfa could be considered a cost-effective strategy in treating CF patients associated with increased benefits compared to Tobramycin.