title: Cost-utility and budget impact analysis of drug treatments in pulmonary arterial hypertension associated with congenital heart diseases in Thailand.
abstract: OBJECTIVE
  This study aims to compare the lifetime costs and health outcomes of both first-line and sequential combination treatments with standard treatment for pulmonary arterial hypertension (PAH) associated with congenital heart disease (CHD) (PAH-CHD) patients.
  
  
  METHODS
  A cost-utility analysis was performed using a Markov model based on a societal perspective. One-way and probabilistic sensitivity analyses were performed to investigate the effect of parameter uncertainty.
  
  
  RESULTS
  As first-line treatments, both beraprost (incremental cost-effectiveness ratio (ICER) = 192,752 and 201,308 Thai baht (THB) per quality-adjusted life year (QALY) gained) and sildenafil (ICER = 249,770 and 226,802 THB per QALY gained) seemed cost-effective for PAH-CHD patients aged ≤30 years in functional classes II and III, respectively, while no treatment was cost-effective for the sequential combination therapy.
  
  
  CONCLUSIONS
  Sildenafil should be included in the National Drug List of Essential Medicines as the first-line treatment for PAH-CHD, and its price per dose should be negotiated to be reduced by 43-57%.
authors.affiliation: a Health Intervention and Technology Assessment Program (HITAP) , Ministry of Public Health , Nonthaburi , Thailand.|b Social and Administrative Pharmacy Excellence Research (SAPER) Unit, Department of Pharmacy, Faculty of Pharmacy , Mahidol University , Bangkok , Thailand.
authors.forename: Watsamon
authors.initials: W
authors.lastname: Thongsri
authors.affiliation: a Health Intervention and Technology Assessment Program (HITAP) , Ministry of Public Health , Nonthaburi , Thailand.
authors.forename: Thanaporn
authors.initials: T
authors.lastname: Bussabawalai
authors.affiliation: a Health Intervention and Technology Assessment Program (HITAP) , Ministry of Public Health , Nonthaburi , Thailand.
authors.forename: Pattara
authors.initials: P
authors.lastname: Leelahavarong
authors.affiliation: c Department of Pediatrics, Faculty of Medicine , Ramathibodi Hospital , Bangkok , Thailand.
authors.forename: Suthep
authors.initials: S
authors.lastname: Wanitkun
authors.affiliation: d Department of Pediatrics, Faculty of Medicine , Siriraj Hospital , Bangkok , Thailand.
authors.forename: Kritvikrom
authors.initials: K
authors.lastname: Durongpisitkul
authors.affiliation: a Health Intervention and Technology Assessment Program (HITAP) , Ministry of Public Health , Nonthaburi , Thailand.|b Social and Administrative Pharmacy Excellence Research (SAPER) Unit, Department of Pharmacy, Faculty of Pharmacy , Mahidol University , Bangkok , Thailand.
authors.forename: Usa
authors.initials: U
authors.lastname: Chaikledkaew
authors.affiliation: a Health Intervention and Technology Assessment Program (HITAP) , Ministry of Public Health , Nonthaburi , Thailand.
authors.forename: Yot
authors.initials: Y
authors.lastname: Teerawattananon
mesh_terms: D000328:Adult; D002017:Budgets; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D018954:Drugs, Essential / Q000191:economics; D011464:Epoprostenol / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000191:economics; D006330:Heart Defects, Congenital / Q000150:complications*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy* / Q000191:economics / Q000209:etiology; D008390:Markov Chains; D019057:Quality-Adjusted Life Years; D000068677:Sildenafil Citrate / Q000008:administration & dosage* / Q000191:economics; D013785:Thailand; D014665:Vasodilator Agents
chemical_list: D018954:Drugs, Essential; D014665:Vasodilator Agents; C048081:beraprost; D000068677:Sildenafil Citrate; D011464:Epoprostenol
keywords: Cost-utility analysis; Thailand; budget impact analysis; congenital heart disease; pulmonary arterial hypertension