Abstract

GUEVARA-CUELLAR, Cesar Augusto. Cost-utility of prednisolone and acyclovir in patients with Bell's palsy in Colombia. Acta Neurol Colomb. [online]. 2014, vol.30, n.4, pp.263-272. ISSN 0120-8748.

Introduction: There are multiple therapeutic alternatives for patients with Bell's palsy, however their efficiency within the Colombian health system is unknown. The objective of this study is to determine the incremental cost-utility ratio (ICUR) and the expected value of perfect information (EVPI) of different treatments for this condition. Materials and methods: A cost-utility analysis was conducted from the perspective of the payer using a decision tree with a time horizon of less than one year. This model evaluated the following alternatives: a. prednisolone only, b. antivirals only, c. a combination of prednisolone and antivirals; d. observation. Direct costs were obtained from national tariff (ISS+30%). Quality adjusted life-years (QALYs) using utility data from secondary sources were calculated. Monte Carlo simulation with 10,000 iterations and 1,000 microsimulation was performed. Results: Expected total costs for prednisolone only: $COP 48,315 (95% CI: 16,434-84,252); observation: $COP 49,868 (95% CI: 22,760-84,540); steroids and antivirals $COP 62,237 (95% CI: 32,112-96,750) and antivirals alone $COP: 96,402 (95% CI: 56372-139926). Every alternative gained 0.72 QALYs (95% CI: 0.68-0.75). Prednisolone alone was the dominant alternative for all values of willingness to pay. The EVPI for the willingness to pay of $COP 47'512,194 and 222'802,847 were $COP: 32'623,700 and 134'383,920 respectively. Conclusion: Prednisolone only is the dominant strategy for any willingness to pay. The EVPI in Colombia for the greater willingness to pay was $ COP: 134'383 .920.

Keywords : Health economics; Cost Efficiency Analysis; Quality-adjusted life years; Bell palsy; prednisolone; acyclovir.

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