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Pharmacoeconomics Final Project Group 10

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Pharmacoeconomics Final Project Group 10

So hi works group stream 10 and our articles on the atomoxetine for the treatment of adults with attention deficit hyperactivity disorder and it’s a cost utility analysis in spain and as you can see here we got an article from pharmaco economics open access right here ok i’m gonna start off so how we evaluated our our article was using the chapter to the 14

Question mark question analysis so starting with question 1 is sukkah is the title complete is the title appropriate we found that the title is appropriate because it included the types of studies which is a cost utility study and it is objective and does not contain any bias statement and there’s two comparator stated as you can see right here the mock right here

In this title so for the second question is a clear objective yes it was a clear objective because and it was stated that in the study it was to estimate the cost utility of a top moxa teen compared with no treatment in the treatment of adults adhd in spain and in – so cific subgroups patient would collaborate it and night anxiety or comorbid alcohol b’s from

The perspective of the spanish national healthcare system so the types of study was query status as well as a comparator and where the study was based off and the study group as well as the perspective all this study clearly stated and you could we found the objective right here in the background of the abstract and was the appropriative or comparators consider it

Was because atomoxetine is the only drug therapy that is approved in spain for adhd treatment and this is the best option available as it is compared to placebo authors provide a descriptive reasoning for why placebo was the best alternative however the authors did mention that limitations of not including cognitive behavioral therapy as in comparator so right here

You can see that the author stated this is the only drug therapy approved in spain and at the end they stated that this was a limitation of not using a non medical therapy as a comparator so next question is was a comprehensive description of the competing alternatives given and now the dosage and length of the therapy was vague and not provided only the number of

Cycles the patient’s was on was specified no information on the dosage selection was given next question is the perspective of the study stated and addressed yes so the perspective of the study was stated as the spanish national healthcare system the healthcare system perspective included direct cost as well as health utility values costs were estimated over a one

Year time period next question is the type of study study yes the type of the study is the cost of utility analysis this is stated in the title of the article as well as in the introduction section so next question is where all of the important and relevant cost included yes so in the article the green highlights part you can see sorry right yeah you can you can

See the study included all of the cost involved including drug acquisition and the treatment monitoring with calculated qaly and i see er pharmacy cost were obtained from the database of the general spanish counsel of the pharmacist treatment monitoring cost were based on published tariffs in spain drug cost were derived from public prices adjusted with a 7.5%

Mandatory rebate where the important or relevant outcomes measured the answer for this question is yes treatment efficacy is measured as clinical response to find on rating scales of course symptoms and effects and outcomes included qualities and icers which is expressed as euros euros per quali which are the measures associated with cost utility analysis and

If you look at the purple highlight on the left hand side there are there are outcomes measured in this study and the next question for our analysis is that were adjustment or discounting appropriate there were no adjustment or discounting was needed for this study because of this continuation rates were based on a post hoc kaplan-meier analysis of the 9 plus evo

Controlled atomoxetine trials and the study took place over a duration of one year so there were no need for adjustment discounting authors stated that one year was considered appropriate duration of adhd treatment from capturing the benefit from the treatments and the study was aligned with the most other published adhd models and longer duration of therapy was

Not necessary since adhd doesn’t have any impact on life expectancy our assumptions stated and reason the answer is yes cost ever assumed included atomoxetine costs treatments monitoring cost with specialist visits but although comorbid conditions might reduce a patient quality of life quality of life equal utility values were assumed for the populations the next

Question is where sensitivity analysis conducted for important estimates or assumptions yes deterministic one-way sensitivity analysis were done to capture the changes in the value of key model parameters an alternative utility values using five q5d questionnaire from lido trial and an alternative treatment response sorry definition were also applied second-order

Proble probabilistic sensitivity analysis were done to estimate the uncertainty of all model parameters on adam austin’s cost-effectiveness potential okay what the human tations address answer is yes the authors mentioned that there were several limitations in the study the comparator was assumed to be no treatment by using the placebo since there is no other

Pharmaceutical treatment indicated for adhd in adults in spain and a limitation is that the patients were only moved to the no response state during the first three cycles as a result of discontinuation from adverse events other reasons we’re not available to accommodate the 12 weeks of time for onset another limitation is that the patient adherence with treatment

In the trial is likely to be higher than in real clinical practice due to the frequent monitoring and the model was sensitive to the utility value changes and the utility data source that was used okay we’re extrapolations beyond the population study proper so this study had very limited generalizations and the extrapolations beyond the population were actually

Not made by the authors the study was conducted in spain so using a specific population may women the generalizability to other patients the authors also did not indicate the actual sample size of the patients which made it difficult to understand the full impact of the treatment and so this missing data woman’s the use of statistical comparisons was an unbiased

Summary of the results presented the answer is yes the conclusion discussed differences in costs and compared them with differences in qa l wise for the patient population this result was compared to the acceptable willingness to pay of 30 thousand euros per cube al y in spain and here’s our citation of the article that we have just reviewed thank you thank you

And the link for this article will be attached below

Transcribed from video
Pharmacoeconomics Final Project Group 10 By Fiona Sun