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Systematic review and cost-effectiveness of bosentan and sildenafil as therapeutic drugs for pediatric pulmonary arterial hypertension
  • +4
  • Bin Zheng,
  • Tingting Chen,
  • Jiahe Chen,
  • Chaoxin Chen,
  • Huanrui Zheng,
  • Yanhui Chen,
  • Maobai Liu
Bin Zheng
Fujian Medical University Union Hospital
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Tingting Chen
Fujian Medical University
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Jiahe Chen
University of Southern California
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Chaoxin Chen
Fujian Medical University
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Huanrui Zheng
Fujian Medical University
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Yanhui Chen
Fujian Medical University Union Hospital
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Maobai Liu
Fujian Medical University Union Hospital
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Abstract

Background:Pulmonary arterial hypertension (PAH) is a rare disease in children, with significant mortality. Because of the limited research on pediatric PAH, firstly systematic review of related drugs is conducted,and then economic evaluation of PAH drug treatment programs is conducted, which to provide a reference for the choice of more cost-effective treatment options. Methods: The search includes electronic databases such as Pubmed, ScienceDirect, Embase. Through inclusion and exclusion criteria, screen high-quality randomized controlled trials. We used TreeAge Pro 2011 software to construct the markov model, that to simulate the total medical cost and quality-adjusted life years (QALYs), and to calculate the incremental cost-effectiveness ratio (ICER). Sensitivity analysis of transfer probability, utility and cost was carried out. Results: Incorporate two studies that meet the criteria, one compared the therapeutic effects of bosentan and placebo on pediatric PAH, the other compared therapeutic effects of sildenafil and placebo on pediatric PAH, both articles were of good quality. Compared with the sildenafil group (3.38QALYs and $161120.14),the QALY of the bosentan treatment group (3.33QALYs and $257411.29) was reduced by 0.05,and the cost increased by $96291.15.The estimated improvement to quality of life and reduced costs result in an estimate of economic dominance for sildenafil over bosentan. This dominant result persisted probabilistic analyses. Conclusions: Based on this model,a more cost-effective treatment drug for PAH in children is sildenafil.

Peer review status:ACCEPTED

12 Oct 2020Submitted to Pediatric Pulmonology
13 Oct 2020Submission Checks Completed
13 Oct 2020Assigned to Editor
09 Nov 2020Reviewer(s) Assigned
31 Mar 2021Review(s) Completed, Editorial Evaluation Pending
31 Mar 2021Editorial Decision: Revise Minor
06 Apr 20211st Revision Received
07 Apr 2021Submission Checks Completed
07 Apr 2021Assigned to Editor
10 Apr 2021Review(s) Completed, Editorial Evaluation Pending
12 Apr 2021Editorial Decision: Accept