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Background: The DAPA-CKD study showed that dapagliflozin added to standard treatment reduced the risk of chronic kidney disease progression, and death from renal or cardiovascular causes compared to placebo. Objective: Assess the cost-effectiveness of dapagliflozin and standard treatment versus standard treatment alone for chronic kidney disease within the Colombian health system. Methods: We employed a Markov model based on the DAPA-CKD study, tailored to the Colombian scenario. The model forecasted hospitalizations for heart failure, overall and cardiovascular mortality, and chronic kidney disease progression over a 10-year horizon with a 5% discount rate. Results: Dapagliflozin combined with standard treatment is a cost-effective intervention in treating stage 2–4 CKD. In the base case, the ICER was US $5,366, below 1 GDP (US $6.558) per capita. This was consistent in the sensitivity analyses. Conclusion: Our study showed that dapagliflozin, when combined with standard treatment, is cost-effective against standard treatment alone, aligning with Colombia's willingness-to-pay threshold. [ABSTRACT FROM AUTHOR]

Objectives: Acquired thrombotic thrombocytopenic purpura (aTTP) is a rare hematological disease whose clinical management includes caplacizumab along with plasma exchange and immunosuppression, according to international guidelines. Caplacizumab has been available in Colombia since 2022. This study seeks to determine the therapeutic classification of caplacizumab according to the methodology of the Instituto de Evaluación Tecnológica en Salud. Methods: The classification was carried out through a deliberative process following the modified Delphi technique, with a panel of experts, made up of four hemato-oncologists, a pharmaceutical chemist, and a patient. The results of effectiveness and safety obtained through a systematic review, therapeutic thresholds (clinical significance), and degree of acceptability (willingness to use the technology) were used for the classification. Results: Fourteen effectiveness and safety outcomes were submitted for the classification process. Caplacizumab showed clinical significance for some effectiveness outcomes, was not considered inferior in terms of safety, and displayed acceptability of use. Through consensus, the panel determined that caplacizumab plus the standard regimen is superior to the standard regimen in terms of treatment response and composite outcome, and no different for the other effectiveness and safety outcomes. Likewise, in overall terms, the panel determined that caplacizumab together with the standard regimen is superior to the standard regimen. Conclusion: Treatment with caplacizumab together with the standard regimen was considered superior to the standard regimen for the treatment of patients with aTTP, as it showed clinically significant benefits in critical outcomes for decision making, and a safety profile no different to its comparator. [ABSTRACT FROM AUTHOR]

The objective of the study was to evaluate the costs and benefits of early identification and treatment (within 24 hours of admission) of patients with aTTP in Colombia. A cost-consequence analysis was conducted to evaluate the costs and health outcomes of diagnosis and early treament versus no treatment (scenario 1) and late treatment (scenario 2) in a hypothetical cohort of 100 patients with aTTP. The analysis perspective was that of the third-party payer. In scenario 1, he total cost of early treatment was USD$515,157 compared to USD$293,265 for no treatment. Early treatment avoided 65 deaths in the hypothetical cohort. The cost per death avoided was USD$3,414. In scenario 2, the cost of early treatment was USD$935,507 compared to USD$809,103 in the late start of treatment. By treating patients early, 33 deaths were avoided, 23 patients were estimated to be alive without exacerbations and 16 without relapses. The cost per death avoided was USD$3,879 and the cost per patient alive without exacerbations and relapses was USD$5,611 and USD$7,858, respectively. The early identification and treatment of patients with aTTP are associated with benefits in survival and recurrence-free survival, and an incremental cost in the process of care compared to no treatment or late treatment. [ABSTRACT FROM AUTHOR]

The DAPA-HF study has shown that dapagliflozin added to standard treatment reduced the risks of worsening of heart failure or cardiovascular death compared to placebo. To evaluate the cost- utility of dapagliflozin in combination with standard treatment compared to standard treatment alone for the treatment of heart failure with reduced ejection fraction from the perspective of the Colombian health system. A Markov model using information from the DAPA-HF study was adapted to the Colombian setting. Health states considered symptom score, and transient health states were included to assess the incidence of consultations and hospitalizations for heart failure. The time horizon was 5 years and a 5% discount rate was applied. The costs were expressed in US dollars of 2020 (1 USD =$3,693.36 COP). The incremental cost-effectiveness ratio (ICER) of the intervention compared to standard treatment was USD $5,946 per quality adjusted life year gained. The ICER remained below the cost-effectiveness threshold in sub-group analyses. 97% of sensitivity analysis simulations showed an ICER below the cost-effectiveness threshold. From the perspective of the analysis, the addition of dapagliflozin to standard treatment is a cost-effective option in patients with heart failure with reduced ejection fraction in Colombia. [ABSTRACT FROM AUTHOR]

Background: Viscosupplementation is a viable alternative for managing knee osteoarthritis, showing potential to delay the need for total joint replacement in affected patients., Methods: We constructed an economic model that compared viscosupplementation with hylan G-F 20, with available hyaluronic acids, and no viscosupplementation over a 5-year period, from the perspective of the Colombian general health system. Time until total knee replacement, sourced from published literature, informed the model. Costs, including acquisition, administration, and knee replacement surgery, were sourced from the local drug prices database and the Ministry of Health's integral information system and expressed in USD., Results: Over 5 years, hylan G-F 20 demonstrated a total cost of USD$45,188,523 compared to hyaluronic acids (USD$50,247,826) and no viscosupplementation (USD$27,345,736). Hylan G-F 20 yielded 39,400 total knee replacement-free years, exceeding hyaluronic acid (30,741) and no viscosupplementation (4,280). Cumulative costs per surgery-free patient showed substantial savings, ranging from USD$1,158 to $6,847 for hylan G-F 20, compared to $1,164 to $74,662 for hyaluronic acid and $5,426 to $6,389 for no viscosupplementation., Conclusions: Hylan G-F 20 showed reduced cost per surgery-free patient compared to hyaluronic acids and no viscosupplementation, enhancing knee replacement-free years.