title: Octreotide long-active release in the treatment of gastrointestinal bleeding due to vascular malformations: Cost-effectiveness study.
abstract: BACKGROUND
  Gastrointestinal hemorrhage due to vascular malformations has a negative impact on patients´ quality of life and consumes an important quantity of resources.
  
  
  OBJECTIVE
  Analyze the cost-effectiveness of long-active releasing octreotide (OCT-LAR) in the treatment of gastrointestinal haemorrhage secondary to vascular malformations.
  
  
  METHODS
  Retrospective study, including 19 pacients that were treated with mensual injections of OCTLAR between 2008-2013. The number of blood transfusions, hemoglobin levels, hospital admissions and possible side effects during the year before treatment and the year after the start of the treatment were assessed, and cost-effectiveness was analyzed.
  
  
  RESULTS
  After the beginning of the treatment with OCTLAR, complete response was observed in 7 patients (36.8 %), partial response in 7 patients (36.8 %) and 5 patients (26.3 %) continued to require admissions, blood transfusions and/or endoscopic treatment. We observed significant reduction in the length of admission per year (in days) before and after the start of the treatment (22.79 versus 2.01 days, p < 0.0001) as well as in the number of blood transfusions administered (11.19 versus 2.55 blood transfusions per year, p = 0.002). The mean haemoglobin levels increased from 6.9 g/dl to 10.62 g/dl (p < 0.0001). We observed reduction of costs of 61.5 % between the two periods (from 36,072.35 € to 13,867.57 € per patient and year, p = 0.01). No side effects related to treatment were described.
  
  
  CONCLUSIONS
  In conclusion, OCT-LAR seems to be a costefficient and safe pharmacological treatment of gastrointestinal haemorrhage secondary to vascular malformations, mainly in patients in whom endoscopic or surgical treatment is contraindicated.
authors: Katerina
authors: K
authors: Klímová
authors: Camilo
authors: C
authors: Padilla-Suárez
authors: Álvaro
authors: Á
authors: Giménez-Manzorro
authors: José Antonio
authors: JA
authors: Pajares-Díaz
authors: Gerardo
authors: G
authors: Clemente-Ricote
authors: Ana
authors: A
authors: Hernando-Alonso
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016888:Angiodysplasia / Q000150:complications* / Q000191:economics; D003362:Cost-Benefit Analysis; D003692:Delayed-Action Preparations; D004334:Drug Administration Schedule; D005260:Female; D020252:Gastric Antral Vascular Ectasia / Q000150:complications / Q000191:economics; D005765:Gastrointestinal Agents / Q000008:administration & dosage* / Q000191:economics / Q000627:therapeutic use; D006471:Gastrointestinal Hemorrhage / Q000188:drug therapy* / Q000191:economics / Q000209:etiology; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000008:administration & dosage* / Q000191:economics / Q000627:therapeutic use; D012189:Retrospective Studies; D013030:Spain; D013272:Stomach Diseases / Q000188:drug therapy* / Q000191:economics / Q000209:etiology
chemical_list: D003692:Delayed-Action Preparations; D005765:Gastrointestinal Agents; D015282:Octreotide