title: [Cost-effectiveness assessment through theoretical cost-minimization analysis of the use of two gastro-resistant modified-release mesalazine formulations in the management of ulcerative colitis in Spain].
abstract: BACKGROUND
  The prevalence of ulcerative colitis (UC) and its associated economic burden is increasing in Spain. Oral mesalazines, which are the recommended first-line treatment for mild-moderate UC, show considerable variability in their formulations and prices.
  
  
  OBJECTIVE
  To carry out a cost-effectiveness assessment of the use of the two formulations of oral gastro-resistant modified-release mesalazine formulations marketed in Spain (Salofalk(®) and Mezavant(®)) for the phases of induction of remission and its maintenance.
  
  
  METHODS
  We adapted internationally validated economic models for the management of UC to the Spanish setting. The adaptation focused on the use of oral gastro-resistant modified-release mesalazines. We conducted cost minimization analyses of remission induction (decision tree) and remission maintenance (Markov model).
  
  
  RESULTS
  For the remission induction, Salofalk(®) 3 g/day was superior to (same effectiveness at lower costs) Mezavant(®) 3.6 g/day and 4.8 g/day in any treatment strategy that included oral gastro-resistant modified-release mesalazines. When compared with Mezavant(®) 2.4 g/day, Salofalk(®) was the most cost-effective option. For remission maintenance, all treatment strategies using Salofalk(®) were the most cost-effective option in all the scenarios considered.
  
  
  CONCLUSIONS
  Because of the lower cost per gram of Salofalk(®), any treatment strategy based on this drug is more cost-effective than Mezavant(®) for the treatment of mild-moderate UC, whether for the induction of remission or for its maintenance.
authors.affiliation: Servicio de Aparato Digestivo, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP) y Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, España.
authors.forename: Javier P
authors.initials: JP
authors.lastname: Gisbert
authors.affiliation: Servicio de Aparato Digestivo, Hospital Clínico Universitario «Lozano Blesa», IIS Aragón, CIBEREHD, Zaragoza, España.
authors.forename: Fernando
authors.initials: F
authors.lastname: Gomollón
authors.affiliation: OXON Epidemiology, Madrid, España. Electronic address: ignacio.mendez@oxonepi.com.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Méndez
mesh_terms: D003093:Colitis, Ulcerative / Q000188:drug therapy* / Q000191:economics; D003362:Cost-Benefit Analysis; D004304:Dosage Forms; D006801:Humans; D019804:Mesalamine / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D018803:Models, Economic; D012074:Remission Induction; D013030:Spain
chemical_list: D004304:Dosage Forms; D019804:Mesalamine
keywords: 5-ASA; Análisis de costes; Colitis ulcerosa; Cost analysis; Enfermedad inflamatoria intestinal; Inflammatory bowel disease; Mesalazina; Mesalazine; Ulcerative colitis