title: The Cost Effectiveness of Lisdexamfetamine Dimesylate for the Treatment of Binge Eating Disorder in the USA.
abstract: BACKGROUND
  Lisdexamfetamine dimesylate (LDX) demonstrated efficacy in terms of reduced binge eating days per week in adults with binge eating disorder (BED) in two randomized clinical trials (RCTs).
  
  
  OBJECTIVE
  The objective of this study was to evaluate the cost effectiveness of LDX versus no pharmacotherapy (NPT) in adults with BED from a USA healthcare payer's perspective.
  
  
  METHODS
  A decision-analytic Markov cohort model was developed using 1-week cycles and a 52-week time horizon. Markov health states were defined based upon the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition criteria of BED. Model parameter estimates were obtained from RCTs, a survey, and literature. The primary outcome was incremental cost-effectiveness ratio (ICER). The analysis assumed a 12-week course of treatment, based upon RCTs' treatment duration. One-way deterministic and probabilistic sensitivity analyses were conducted to assess the robustness of the results.
  
  
  RESULTS
  Patients on LDX therapy gained 0.006 quality-adjusted life years (QALY) compared to patients on the NPT arm, while the average total cost was US$175 higher for LDX therapy. The estimated ICER for LDX compared with NPT was US$27,618 per QALY, which was shown to be cost effective given a willingness-to-pay threshold of US$50,000.
  
  
  CONCLUSIONS
  Treatment of BED with LDX showed increase in QALYs at an acceptable cost and is considered to be cost effective at the commonly used willingness-to-pay threshold in the USA. Based on the available evidence, the current model focused on short-term benefits only. There is a need to generate additional scientific evidence supporting long-term benefits of LDX therapy for BED.
authors.affiliation: Syreon Research Institute, 119 Thököly Street, 1146, Budapest, Hungary. tamas.agh@syreon.eu.
authors.forename: Tamás
authors.initials: T
authors.lastname: Ágh
authors.affiliation: Shire, 735 Chesterbrook Boulevard, Wayne, PA, 19087, USA.
authors.forename: Manjiri
authors.initials: M
authors.lastname: Pawaskar
authors.affiliation: Syreon Research Institute, 119 Thököly Street, 1146, Budapest, Hungary.|Department of Health Policy and Health Economics, Faculty of Social Sciences, Eötvös Loránd University, 1/a Pázmány Péter Street, 1117, Budapest, Hungary.
authors.forename: Balázs
authors.initials: B
authors.lastname: Nagy
authors.affiliation: Faculty of Pharmacy, University of Montreal, 2940 Chemin de la Polytechnique, Montréal, QC, H3T 1J4, Canada.
authors.forename: Jean
authors.initials: J
authors.lastname: Lachaine
authors.affiliation: Syreon Research Institute, 119 Thököly Street, 1146, Budapest, Hungary.|Department of Health Policy and Health Economics, Faculty of Social Sciences, Eötvös Loránd University, 1/a Pázmány Péter Street, 1117, Budapest, Hungary.
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Vokó
mesh_terms: D000328:Adult; D001067:Appetite Depressants / Q000191:economics* / Q000627:therapeutic use*; D056912:Binge-Eating Disorder / Q000188:drug therapy* / Q000191:economics* / Q000523:psychology; D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D039721:Diagnostic and Statistical Manual of Mental Disorders; D006801:Humans; D000069478:Lisdexamfetamine Dimesylate / Q000191:economics* / Q000627:therapeutic use*; D008390:Markov Chains; D015233:Models, Statistical; D019057:Quality-Adjusted Life Years; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D014481:United States
chemical_list: D001067:Appetite Depressants; D000069478:Lisdexamfetamine Dimesylate