The cost-effectiveness of macrogol 3350 compared to lactulose in the treatment of adults suffering from chronic constipation in the UK.
BACKGROUND
It is unknown whether macrogol 3350 (Movicol) affords the UK's National Health Service (NHS) a cost-effective addition to the current range of laxatives.


OBJECTIVE
To estimate the cost-effectiveness of macrogol 3350 compared with lactulose in the treatment of chronic constipation, from the perspective of the UK's NHS.


METHODS
A decision model depicting the management of chronic constipation was constructed using clinical outcomes and resource use values derived from patients suffering from chronic constipation in The Health Independent Network (THIN) database. The model was used to estimate the cost-effectiveness of a GP prescribing macrogol 3350 instead of lactulose to treat adults > or =18 years of age suffering from chronic constipation.


RESULTS
Sixty-eight percent of patients given macrogol 3350 were successfully treated within 6 months after starting treatment compared to 60% of patients given lactulose.Patients' health status at 6 months was estimated to be 0.458 and 0.454 quality-adjusted life years (QALYs) in the macrogol 3350 and lactulose groups respectively. The total 6-monthly NHS cost of initially treating patients with macrogol 3350 or lactulose was estimated to be pound420 (US $688) and pound419 (US $686) respectively. Hence, the cost per QALY gained with macrogol 3350 was estimated to be pound250 (US $410).


CONCLUSIONS
Macrogol 3350 affords the NHS a cost-effective addition to the range of laxatives available for this potentially resource-intensive condition.
Taylor
R R
RR
Catalyst Health Economics Consultants, Northwood, Middlesex, UK.
Guest
J F
JF
D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003248:Constipation / Q000188:drug therapy / Q000191:economics*; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D007792:Lactulose / Q000191:economics* / Q000627:therapeutic use; D054368:Laxatives / Q000191:economics* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D018803:Models, Economic; D009313:National Health Programs / Q000191:economics*; D011092:Polyethylene Glycols / Q000627:therapeutic use; D011788:Quality of Life; D016896:Treatment Outcome; D006113:United Kingdom
D054368:Laxatives; D011092:Polyethylene Glycols; D007792:Lactulose