Publication detail

Indirect treatment comparison and cost-minimization analysis of riociguat versus selexipag in patients with pulmonary arterial hypertension

Author(s): Mgr. Kateřina Chadimová , Mgr. Eva Ornstová; Mgr. Jan Tužil; Ing. Tomáš Mlčoch; MUDr. Tomáš Doležal, Ph.D.
Type: Articles in journals with impact factor
Year: 2022
Number: 22
ISSN / ISBN:
Published in: Expert Review of Pharmacoeconomics & Outcomes Research
Publishing place:
Keywords: Bucher indirect comparison, cost-minimization analysis, riociguat, selexipag, pulmonary arterial hypertension, systematic review
JEL codes:
Suggested Citation: Eva Ornstová, Jan Tužil, Kateřina Chadimová, Tomáš Mlčoch & Tomáš Doležal (2022) Indirect treatment comparison and cost-minimization analysis of riociguat versus selexipag in patients with pulmonary arterial hypertension, Expert Review of Pharmacoeconomics & Outcomes Research, DOI: 10.1080/14737167.2022.2126833
Abstract: Objectives
The comparative efficacy between riociguat and selexipag in patients with pulmonary arterial hypertension (PAH) has never been described in literature. Our aim was to prepare indirect treatment comparison (ITC) to evaluate the cost-effectiveness of riociguat in Czechia.

Methods
A systematic literature review identified two relevant trials with comparable endpoints to inform a Bucher ITC of relative and absolute effects. Given the comparable efficacy of riociguat and selexipag, a cost-minimization analysis (CMA) was conducted.

Results
A Bucher ITC provided evidence for the comparable relative efficacy of riociguat defined as the odds of unimproved functional class III 0.761 (95% CI 0.372 to 1.558; p = 0.455) compared to selexipag and a comparable absolute efficacy defined as a difference in the 6-minute walking distance of 10.560 meters (95% CI −10.692 to 31.812; p = 0.330). The CMA identified riociguat as the cost-saving therapy.

Conclusions
Switching to riociguat represents the cost-saving therapy for PAH patients who were inadequately compensated with the PDE5i+ERA therapy. Consequently, riociguat has been introduced to the list of reimbursed medicines in Czechia from October 2021. Based on two global trials, we prepared the first indirect treatment comparison followed with CMA of these therapies that may improve future decision-making for PAH indications.
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