title: Assessment of real-world usage of lanreotide AUTOGEL 120 in Polish acromegalic patients - results from the prospective 12-month phase of Lanro-Study.
abstract: OBJECTIVE
  To assess resource utilization and costs of treatment with lanreotide AUTOGEL 120 mg (ATG120) administered as part of routine acromegaly care in Poland.
  
  
  METHODS
  A multicentre, non-interventional, observational study on resource utilization in Polish acromegalic patients treated with ATG120 at 4 weeks or extended (> 4 weeks) dosing interval. The study recruited adult acromegalic patients treated medically for ≥ 1 year including at least 3 injections of ATG120. Data on dosing interval, aspects of administration, and resource utilization were collected prospectively during 12 months. Costs were calculated in PLN from the public health-care payer perspective for the year 2013.
  
  
  RESULTS
  139 patients were included in the analysis. Changes in dosing regimen were reported in 14 (9.4%) patients. Combined treatment was used in 11 (8%) patients. Seventy patients (50%) received ATG120 at an extended dosing interval; the mean number of days between injections was 35.56 (SD 8.4). ATG120 was predominantly administered in an out-patient setting (77%), by health-care professionals (94%). Mean time needed for preparation and administration was 4.33 and 1.58 min, respectively, mean product wastage - 0.13 mg. Patients were predominantly treated in an out-patient setting with 7.06 physician visits/patient/year. The most common control examinations were magnetic resonance imaging of brain and brain stem (1.36/patient/year), ultrasound of the neck (1.35/patient/year), GH (1.69/patient/year), glycaemia (1.12/patient/year), IGF-1 (0.84/patient/year), pituitary-thyroid axis hormone levels assessment (TSH-0.58/patient/year, T4-0.78/patient/year). There were 0.43 hospitalizations/patient/year. For direct medical costs estimated at PLN 50 692/patient/year the main item was the costs of ATG120 (PLN 4103.87/patient/month; 97%). The mean medical cost, excluding pharmacotherapy, was PLN 1445/patient/year (out-patient care - 49%, hospitalization - 23%, diagnostics/laboratory tests - 28%).
  
  
  CONCLUSIONS
  These results represent the current use of ATG120 in the population of Polish acromegalic patients in a realistic clinical setting. Findings that 50% of patients could be treated with dose intervals of longer than 28 days support the potential of ATG120 to reduce the treatment burden.
authors.affiliation: Centre for Pharmacoeconomics, Warsaw, Poland.
authors.forename: Ewa
authors.initials: E
authors.lastname: Orlewska
authors.affiliation: Division of Endocrinology, Department of Pathophysiology and Endocrinology, Silesian Medical University, Katowice, Poland.
authors.forename: Beata
authors.initials: B
authors.lastname: Kos-Kudła
authors.affiliation: Chair and Department of Endocrinology, Metabolism and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland.
authors.forename: Jerzy
authors.initials: J
authors.lastname: Sowiński
authors.affiliation: Endocrinology and Internal Diseases Department, Medical University, Gdansk, Poland.
authors.forename: Krzysztof
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authors.lastname: Sworczak
authors.affiliation: Endocrinology Department Medical Center of Postgraduate Education, Warsaw, Poland.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Zgliczyński
authors.affiliation: Endocrinology, Metabolic Diseases and Internal Medicine Department, Pomeranian Medical University, Szczecin.
authors.forename: Elżbieta
authors.initials: E
authors.lastname: Andrysiak-Mamos
authors.affiliation: Endocrinology and Internal Diseases Department, Medical University, Gdansk, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Babińska
authors.affiliation: Endocrinology Department, University Hospital, Krakow.
authors.forename: Agata
authors.initials: A
authors.lastname: Bałdys-Waligórska
authors.affiliation: Endocrinology, Diabetology and Internal Medicine Department, University of Warmia and Masuria, Olsztyn.
authors.forename: Elżbieta
authors.initials: E
authors.lastname: Bandurska-Stankiewicz
authors.affiliation: Endocrinology and Internal Diseases Department, Medical University, Gdansk, Poland.
authors.forename: Krzysztof
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authors.lastname: Błaut
authors.affiliation: Clinical Practice, Plewiska.
authors.forename: Paweł
authors.initials: P
authors.lastname: Bolko
authors.affiliation: Division of Endocrinology, Department of Pathophysiology and Endocrinology, Silesian Medical University, Katowice, Poland.
authors.forename: Wanda
authors.initials: W
authors.lastname: Foltyn
authors.affiliation: Endocrinology, Diabetology and Internal Medicine Department, Medical Academy University, Bialystok.
authors.forename: Danuta
authors.initials: D
authors.lastname: Jakubczyk
authors.affiliation: Chair and Department of Endocrinology and Diabetology, Wroclaw Medical University, Wroclaw.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Jawiarczyk-Przybyłowska
authors.affiliation: Endocrinology and Diabetology Department, University Hospital, Bydgoszcz.
authors.forename: Roman
authors.initials: R
authors.lastname: Junik
authors.affiliation: Endocrinology and Diabetology Department, University Hospital, Bydgoszcz.
authors.forename: Olga
authors.initials: O
authors.lastname: Juraniec
authors.affiliation: Endocrinology Department, University Hospital, Krakow.
authors.forename: Ewelina
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authors.lastname: Lewkowicz
authors.affiliation: Endocrinology and Internal Diseases Department, Medical University, Gdansk, Poland.
authors.forename: Anna
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authors.lastname: Lewczuk
authors.affiliation: Endocrinology and Internal Medicine Department, Public Clinical Hospital, Lublin.
authors.forename: Beata
authors.initials: B
authors.lastname: Matyjaszek-Matuszek
authors.affiliation: Chair and Department of Endocrinology, Metabolism and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Michałek
authors.affiliation: Endocrinology Office, Lodz.
authors.forename: Sławomir
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authors.affiliation: Endocrinology Clinic, Hospital no 2, Rzeszow.
authors.forename: Renata
authors.initials: R
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authors.affiliation: Endocrinology Clinic, Tarnowskie Gory.
authors.forename: Marta
authors.initials: M
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authors.affiliation: Diabetological and Internal Medicine Clinic, Szczecin.
authors.forename: Sławomir
authors.initials: S
authors.lastname: Pynka
authors.affiliation: Division of Endocrinology, Department of Pathophysiology and Endocrinology, Silesian Medical University, Katowice, Poland.
authors.forename: Violetta
authors.initials: V
authors.lastname: Rosiek
authors.affiliation: Chair and Department of Endocrinology, Metabolism and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland.
authors.forename: Marek
authors.initials: M
authors.lastname: Ruchała
authors.affiliation: Endocrinology, Diabetology and Internal Medicine Department, University of Warmia and Masuria, Olsztyn.
authors.forename: Joanna
authors.initials: J
authors.lastname: Rutkowska
authors.affiliation: Chair and Department of Endocrinology, Metabolism and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland.
authors.forename: Julia
authors.initials: J
authors.lastname: Słynko-Krzyzostaniak
authors.affiliation: Endocrinology Department, University Hospital, Krakow.
authors.forename: Agnieszka
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authors.lastname: Stefańska
authors.affiliation: Division of Endocrinology, Department of Pathophysiology and Endocrinology, Silesian Medical University, Katowice, Poland.
authors.forename: Janusz
authors.initials: J
authors.lastname: Strzelczyk
authors.affiliation: Endocrinology, Metabolic Diseases and Internal Medicine Department, Pomeranian Medical University, Szczecin.
authors.forename: Anhelli
authors.initials: A
authors.lastname: Syrenicz
authors.affiliation: Endocrinology Department, University Hospital, Krakow.
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Trofimiuk-Müldner
authors.affiliation: Chair and Department of Endocrinology, Metabolism and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland.
authors.forename: Joanna
authors.initials: J
authors.lastname: Waligórska-Stachura
authors.affiliation: Chair and Department of Endocrinology, Metabolism and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland.
authors.forename: Ryszard
authors.initials: R
authors.lastname: Waśko
authors.affiliation: Department of Endocrinology and Isotope Therapy, Military Institute of Medicine, Warsaw.
authors.forename: Przemysław
authors.initials: P
authors.lastname: Witek
authors.affiliation: Endocrinology and Diabetology Department, University Hospital, Bydgoszcz.
authors.forename: Danuta
authors.initials: D
authors.lastname: Zalewska-Rydzkowska
authors.affiliation: Endocrinology Department Medical Center of Postgraduate Education, Warsaw, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Zdunowski
authors.affiliation: Division of Endocrinology, Department of Pathophysiology and Endocrinology, Silesian Medical University, Katowice, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Zemczak
keywords: acromegaly; clinical study; costs of treatment; lanreotide