Clinical and economic efficiency of multi-matrix mesalazine in ulcerative colitis treatment in the healthcare system of the Republic of Kazakhstan

Клинико-экономическая эффективность мультиматричного месалазина в терапии неспецифического язвенного колита в условиях здравоохранения Республики Казахстан
Alima Almadiyeva 1, Venera Almatova 2, Timur Balabayev 3, Marat Sultanov 4, Karlygash Absattarova 1 *
More Detail
1 Public Healthcare Department, Kazakhstani Agency on Healthcare Technologies Assessment, Nur-Sultan city, Republic of Kazakhstan
2 Department of Radiodiagnosis and Radiotherapy, Astana Medical University, Nur-Sultan city, Republic of Kazakhstan city, Republic of Kazakhstan
3 Public Healthcare Department, Kazakhstan Association of Healthcare Technologies Assessment, Evidencebased Medicine and Pharmacoeconomics Research “KazSPOR”, Nur-Sultan city, Republic of Kazakhstan city, Republic of Kazakhstan
4 Public Healthcare Department, Nazarbayev University, Nur-Sultan city, Republic of Kazakhstan
* Corresponding Author
J CLIN MED KAZ, Volume 2, Issue 52, pp. 30-36. https://doi.org/10.23950/1812-2892-JCMK-00680
OPEN ACCESS 3357 Views 3169 Downloads
Download Full Text (PDF)

ABSTRACT

Aim: Clinical and economic evaluation of multi-matrix mesalazine 1200 mg compared with prolonged-release mesalazine at a dose of 500mg for the treatment of patients aged 18 years and older with the diagnosis of ulcerative colitis in the phase of exacerbation and remission.
Material and methods: In accordance with the PICOS tool all published literature sources were identified in the electronic resources PubMed/Medline, DARE, Cochrane Central Register of Controlled Trials; the analysis included 5 studies with levels of evidence A and B. Calculations were performed in STATA and Microsoft Excel 10.0
Results and discussion: According to the results of clinical and economic analysis, the strategy of using multi-matrix mesalazine is dominant in comparison with prolonged-release mesalazine as a first-line therapy and contributes to the increment of efficiency and leads to the minimization of costs to achieve a QALY unit per patient. Patients receiving multi-matrix mesalazine have a longer duration of remission and less likelihood of re-exacerbations.
Conclusion: The use of multi-matrix mesalazine in comparison with prolonged-release mesalazine is an economically feasible alternative in the conditions of health care of the Republic of Kazakhstan – more effective and less financially costly, leading to potential budget savings.
Keywords: multi-matrix mesalazine, non-specific ulcerative colitis, Crohn's disease, efficacy, QALY

CITATION

Almadiyeva A, Almatova V, Balabayev T, Sultanov M, Absattarova K. Clinical and economic efficiency of multi-matrix mesalazine in ulcerative colitis treatment in the healthcare system of the Republic of Kazakhstan. Journal of Clinical Medicine of Kazakhstan. 2019;2(52):30-6. https://doi.org/10.23950/1812-2892-JCMK-00680

REFERENCES

  • Burisch, J., & Munkholm, P. The epidemiology of inflammatory bowel disease. Scandinavian Journal of Gastroenterology. 2015; 50(8):942-951. https://doi.org/10.3109/00365521.2015.1014407
  • Feagan BG, Macdonald JK. Oral 5-aminosalicylic acid for induction of remission in ulcerative colitis. Cochrane Database Syst Rev. 2012; 10:CD000543. https://doi.org/10.1002/14651858.CD000543.pub3
  • Feagan BG, et al. Are there any differences in the efficacy and safety of different formulations of oral 5-ASA used for induction and maintenance of remission in ulcerative colitis? Evidence from cochrane reviews. Inflamm Bowel Dis. 2013; 19:2031-2040. https://doi.org/10.1097/MIB.0b013e3182920108
  • Prenzler A, et al. Cost effectiveness of ulcerative colitis treatment in Germany: A comparison of two oral formulations of mesalazine. BMC Health Services Research. 2011; 11. https://doi.org/10.1186/1472-6963-11-157
  • Nishikawa A. M., Paladini L., Delfini R., Kotze P. G., Clark O. Decision tree construction and cost-effectiveness analysis of treatment of ulcerative colitis with pentasa ® mesalazine 2 g sachet. Arquivos de Gastroenterologia. 2013; 50(4):297-303. https://doi.org/10.1590/S0004-28032013000400011
  • Yen, E. F., et al. Cost-Effectiveness of 5-Aminosalicylic Acid Therapy for Maintenance of Remission in Ulcerative Colitis. The American Journal of Gastroenterology. 2008; 103(12):3094-3105. https://doi.org/10.1111/j.1572-0241.2008.02130.x
  • Brereton N, et al. A cost-effectiveness analysis of MMX mesalazine compared with mesalazine in the treatment of mildto-moderate ulcerative colitis from a UK perspective. Journal of Medical Economics. 2010; 13(1):148-61. https://doi.org/10.3111/13696990903562861
  • Buckland A., Bodger K. The cost-utility of high dose oral mesalazine for moderately active ulcerative colitis. Alimentary Pharmacology & Therapeutics. 2008; 28(11-12):1287-1296. https://doi.org/10.1111/j.1365-2036.2008.03856.x
  • Saini S. D., et al. Cost Utility of Inflammation-Targeted Therapy for Patients with Ulcerative Colitis. Clinical Gastroenterology and Hepatology. 2012; 10(10):1143-1151. https://doi.org/10.1016/j.cgh.2012.05.003
  • Connolly MP, et al. The economics of mesalazine in active ulcerative colitis and maintenance in the Netherlands. Netherlands Journal of Medicine. 2012; 70(6):272-7.
  • Tappenden P, Ren S, Archer R, Harvey R, James MM, Basarir H, et al. A Model-Based Economic Evaluation of Biologic and Non-Biologic Options for the Treatment of Adults with Moderately-to-Severely Active Ulcerative Colitis after the Failure of Conventional Therapy. Pharmacoeconomics. 2016; 34(10):1023-38. https://doi.org/10.1007/s40273-016-0409-9 
  • J. P. Gisbert, F. et al. Evaluación de coste-efectividad mediante análisis teórico de minimización de costes del uso de dos mesalazinas gastrorresistentes de liberación prolongada en el manejo de la colitis ulcerosa. en España Gastroenterología y Hepatología, 2016; 39(3):199-212 https://doi.org/10.1016/j.gastrohep.2015.04.014
  • Kruis W, et al. Once daily versus three times daily mesalazine granules in active ulcerative colitis: a double-blind, double-dummy, randomised, non-inferiority trial. Gut. 2009; 58:233-240. https://doi.org/10.1136/gut.2008.154302
  • G.R. D’Haens, et al. Randomised non-inferiority trial: 1600 mg versus 400 mg tablets of mesalazine for the treatment of mild-tomoderate ulcerative colitis. Aliment Pharmacol Ther. 2017; 1-11. https://doi.org/10.1111/apt.14164
  • Lichtenstein GR, et al. Effect of once- or twice-daily MMX mesalamine (SPD476) for the induction of remission of mild to moderate active ulcerative colitis. Clin Gastroenterol Hepatol. 2007; 5:95-102. https://doi.org/10.1016/j.cgh.2006.10.025
  • Flourie B, et al. Randomised clinical trial: once- vs twice-daily prolonged-release mesalazine for active ulcerative colitis. Aliment Pharmacol Ther. 2013; 37:767-775. https://doi.org/10.1111/apt.12266
  • Kamm MA, et al. Randomised trial of once- or twice-daily MMX mesalazine for maintenance of remission in ulcerative colitis. Gut. 2008; 57:893-902. https://doi.org/10.1136/gut.2007.138248
  • Scott D. et al. Good Research Practices for Cost-Effectiveness Analysis alongside Clinical Trials. The ISPOR RCT-CEA Task Force Report. Value in Health. 2005; 8,:521-533. https://doi.org/10.1111/j.1524-4733.2005.00045.x
  • Prikaz Ministra zdravoohranenija i social’nogo razvitija RK ot 16 sentjabrja 2015 goda № 725 «Ob utverzhdenii tarifov na medicinskie uslugi v ramkah rekomendacij klinicheskogo protokola diagnostiki i lechenija «Jazvennyj kolit» (odobrennogo protokol’nym resheniem № 23 Ob#edinennoj komissiej po kachestvu medicinskih uslug MZ RK ot 25maja 2017 goda) [in Russian]. https://diseases.medelement.com/disease/язвенный-колит/15033
  • Ministerstvo nacional’noj jekonomiki RK. Komitet po statistike. Dinamika osnovnyh social’no-jekonomicheskih pokazatelej. [in Russian]. Dostupno na www.stat.gov.kz http://stat.gov.kz/getImg?id=ESTAT101987
  • Schroeder K. W., Tremaine W. J., Ilstrup D. M. Coated oral 5-aminosalicylic acid therapy for mildly to moderately active ulcerative colitis. A randomized study. N Engl J Med. 1987; 317:1625-1629. https://doi.org/10.1056/NEJM198712243172603
  • Ko, C.W., Singh, S., Feuerstein, J.D., Falck-Ytter, C., Falck-Ytter, Y., Cross, R.K. American Gastroenterological Association Institute Guideline on the Management of Mild-to-Moderate Ulcerative Colitis. Gastroenterology. 2019; 156(3):748-764. https://doi.org/10.1053/j.gastro.2018.12.009
  • Valovoi vnutrennii product na dushu naseleniya. Kommitet po statistike Ministerstva natsionalnoi ekonomiki RK. Dostupno na http://stat.gov.kz/getImg?id=ESTAT101987
  • Matsuoka K., Kobayashi T., Oeno F., Matsui T., Hirai F., Inoue N., Evidence-based clinical practice guidelines for inflammatory bowel disease. J Gastroenterol. 2018; 53(3):305-353 https://doi.org/10.1007/s00535-018-1439-1
  • Robinson A, Hankins M, Wiseman G, Jones M. Maintaining stable symptom control in inflammatory bowel disease: a retrospective analysis of adherence, medication switches and the risk of relapse. Aliment Pharmacol Ther. 2013; 38:53-538 https://doi.org/10.1111/apt.12396
  • Danese S, Banerjee R, Cummings JF, et al. Consensus recommendations for patient-centered therapy in mild-to-moderate ulcerative colitis: the i Support Therapy-Access to Rapid Treatment (iSTART) approach. Intest Res. 2018; 16(4):522-528. https://doi.org/10.5217/ir.2018.00073
  • Jeon SR. Is once daily multimatrix mesalazine therapy effective regardless of the dose in patients with mild to moderate ulcerative colitis? Intest Res. 2018; 16(2):163-165. https://doi.org/10.5217/ir.2018.16.2.163
  • Ogata H, Yokoyama T, Mizushima S, Hagino A, Hibi T. Comparison of efficacy of once daily multimatrix mesalazine 2.4 g/day and 4.8 g/day with other 5-aminosalicylic acid preparation in active ulcerative colitis: a randomized, double-blind study. Intest Res. 2018;16(2):255-266. https://doi.org/10.5217/ir.2018.16.2.255