Cost-effectiveness analysis of second-line medical therapies in acromegaly: a real-life study
IntroductionAcromegaly is an uncommon disease with important comorbidity and economic cost. Although the pharmacological cost of second-line treatment for refractory acromegaly has been theoretically analyzed, real-life studies are needed.ObjectivesTo assess the use of pasireotide and pegvisomant in...
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Frontiers Media S.A.
2025-04-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2025.1573721/full |
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| author | Eva Venegas Moreno Eva Venegas Moreno Andrés Jiménez-Sánchez Andrés Jiménez-Sánchez Pablo Remón-Ruiz Pablo Remón-Ruiz Elena Dios Elena Dios Jaime Perea Cortés Celia Hernández-Reina David A. Cano Alfonso Soto Moreno Alfonso Soto Moreno |
| author_facet | Eva Venegas Moreno Eva Venegas Moreno Andrés Jiménez-Sánchez Andrés Jiménez-Sánchez Pablo Remón-Ruiz Pablo Remón-Ruiz Elena Dios Elena Dios Jaime Perea Cortés Celia Hernández-Reina David A. Cano Alfonso Soto Moreno Alfonso Soto Moreno |
| author_sort | Eva Venegas Moreno |
| collection | DOAJ |
| description | IntroductionAcromegaly is an uncommon disease with important comorbidity and economic cost. Although the pharmacological cost of second-line treatment for refractory acromegaly has been theoretically analyzed, real-life studies are needed.ObjectivesTo assess the use of pasireotide and pegvisomant in a third-level center under routine clinical practice.MethodsAcromegaly patients that had been treated with pasireotide and/or pegvisomant were included in (A) a cross-sectional study (two years after starting these drugs) to analyze the cost of acromegaly, hormone replacement, and type 2 diabetes mellitus (T2DM) treatments, and the cost of surgery and radiotherapy; and (B) a retrospective cohorts study (May 2006—October 2024) to analyze efficacy, safety (adverse events, fasting glucose, glycated hemoglobin, and T2DM diagnosis), and dose evolution. Descriptive statistics were 10% trimmed means and standard deviation. Two-tailed hypothesis testing with Yuen’s t and Fisher’s test had a P < 0.05 significance.Results25 participants were included in the transversal study and 31 participants in the longitudinal study. A typical patient with a poorly granulated GH-producing adenoma underwent in-center surgery once and received radiotherapy. In the transversal study, total pharmacological cost was 34,139.29 (13,472.09) €/person/year, with 33,874.88 (13,468.36) €/person/year for second-line acromegaly drugs. Pasireotide displayed 9,423.26 €/person/year worth of savings (P = .12), reaching 30,415.98 €/person/year at high dose (P < 0.001). In the longitudinal study, pasireotide dose was reduced (P = .06) regardless of treatment modality. Pasireotide affected carbohydrate metabolism (P = .001), but the effect was generally mild.ConclusionsPasireotide was found to be a more cost-effective option in patients with first-line treatment failure. |
| format | Article |
| id | doaj-art-ff51ec6879ee471aa3244208829fa228 |
| institution | OA Journals |
| issn | 1664-2392 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Endocrinology |
| spelling | doaj-art-ff51ec6879ee471aa3244208829fa2282025-08-20T02:20:00ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-04-011610.3389/fendo.2025.15737211573721Cost-effectiveness analysis of second-line medical therapies in acromegaly: a real-life studyEva Venegas Moreno0Eva Venegas Moreno1Andrés Jiménez-Sánchez2Andrés Jiménez-Sánchez3Pablo Remón-Ruiz4Pablo Remón-Ruiz5Elena Dios6Elena Dios7Jaime Perea Cortés8Celia Hernández-Reina9David A. Cano10Alfonso Soto Moreno11Alfonso Soto Moreno12Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Seville, SpainInstituto de Biomedicina de Sevilla, IBiS/Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, SpainUnidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Seville, SpainInstituto de Biomedicina de Sevilla, IBiS/Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, SpainUnidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Seville, SpainInstituto de Biomedicina de Sevilla, IBiS/Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, SpainUnidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Seville, SpainInstituto de Biomedicina de Sevilla, IBiS/Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, SpainInstituto de Biomedicina de Sevilla, IBiS/Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, SpainUnidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Seville, SpainInstituto de Biomedicina de Sevilla, IBiS/Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, SpainUnidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Seville, SpainInstituto de Biomedicina de Sevilla, IBiS/Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, SpainIntroductionAcromegaly is an uncommon disease with important comorbidity and economic cost. Although the pharmacological cost of second-line treatment for refractory acromegaly has been theoretically analyzed, real-life studies are needed.ObjectivesTo assess the use of pasireotide and pegvisomant in a third-level center under routine clinical practice.MethodsAcromegaly patients that had been treated with pasireotide and/or pegvisomant were included in (A) a cross-sectional study (two years after starting these drugs) to analyze the cost of acromegaly, hormone replacement, and type 2 diabetes mellitus (T2DM) treatments, and the cost of surgery and radiotherapy; and (B) a retrospective cohorts study (May 2006—October 2024) to analyze efficacy, safety (adverse events, fasting glucose, glycated hemoglobin, and T2DM diagnosis), and dose evolution. Descriptive statistics were 10% trimmed means and standard deviation. Two-tailed hypothesis testing with Yuen’s t and Fisher’s test had a P < 0.05 significance.Results25 participants were included in the transversal study and 31 participants in the longitudinal study. A typical patient with a poorly granulated GH-producing adenoma underwent in-center surgery once and received radiotherapy. In the transversal study, total pharmacological cost was 34,139.29 (13,472.09) €/person/year, with 33,874.88 (13,468.36) €/person/year for second-line acromegaly drugs. Pasireotide displayed 9,423.26 €/person/year worth of savings (P = .12), reaching 30,415.98 €/person/year at high dose (P < 0.001). In the longitudinal study, pasireotide dose was reduced (P = .06) regardless of treatment modality. Pasireotide affected carbohydrate metabolism (P = .001), but the effect was generally mild.ConclusionsPasireotide was found to be a more cost-effective option in patients with first-line treatment failure.https://www.frontiersin.org/articles/10.3389/fendo.2025.1573721/fullacromegalypasireotidepegvisomantcost analysisradiotherapy |
| spellingShingle | Eva Venegas Moreno Eva Venegas Moreno Andrés Jiménez-Sánchez Andrés Jiménez-Sánchez Pablo Remón-Ruiz Pablo Remón-Ruiz Elena Dios Elena Dios Jaime Perea Cortés Celia Hernández-Reina David A. Cano Alfonso Soto Moreno Alfonso Soto Moreno Cost-effectiveness analysis of second-line medical therapies in acromegaly: a real-life study Frontiers in Endocrinology acromegaly pasireotide pegvisomant cost analysis radiotherapy |
| title | Cost-effectiveness analysis of second-line medical therapies in acromegaly: a real-life study |
| title_full | Cost-effectiveness analysis of second-line medical therapies in acromegaly: a real-life study |
| title_fullStr | Cost-effectiveness analysis of second-line medical therapies in acromegaly: a real-life study |
| title_full_unstemmed | Cost-effectiveness analysis of second-line medical therapies in acromegaly: a real-life study |
| title_short | Cost-effectiveness analysis of second-line medical therapies in acromegaly: a real-life study |
| title_sort | cost effectiveness analysis of second line medical therapies in acromegaly a real life study |
| topic | acromegaly pasireotide pegvisomant cost analysis radiotherapy |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2025.1573721/full |
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