Table 3.
Pharmacoeconomic profile of rifaximin
| Country | Patient characteristics | Endpoint(s) and model | Outcomes |
|---|---|---|---|
| Belgium [61] | Recurrent overt HE | ICER, derived from QALY Markov state transition model |
Lactulose (SOC) Average cost (2010): €44,190 1.9 QALY/pt Average cost effectiveness: €23,258/QALY Rifaximin + lactulose Average cost: €31,262 2.5 QALY/pt Average cost effectiveness: €12,505/QALY ICER: €21,547/QALY for rifaximin + lactulose vs. lactulose |
| France [57] | History of overt HE (≥ 2 episodes); currently in remission | ICER, derived from QALY Markov state transition model |
Lactulose (SOC) 2 years Cost: €5503 0.967 QALY/pt 5 years Cost: €8555 1.778 QALY/pt Rifaximin + lactulose 2 years Cost: €7639 1.078 LY/pt 5 years Cost: €14,411 2.094 QALY ICER 2 years: €19,187/QALY for rifaximin + lactulose vs. lactulose 5 years: €18,517/QALY for rifaximin + lactulose vs. lactulose |
| Netherlands [59] | Recurrent overt HE | ICER, derived from QALY Markov state transition model |
Lactulose (SOC) Average cost (2010): €82,968 1.89 QALY/pt Rifaximin + lactulose Average cost: €88,386 2.45 QALY/pt ICER (5 years): €9576/QALY for rifaximin + lactulose vs. lactulose |
| Sweden [60] | Recurrent overt HE | ICER, derived from QALY Markov state transition model |
Lactulose (SOC) Average cost (2012): €42,522 1.83 QALY/pt Rifaximin + lactulose Average cost: €32,667 2.38 QALY/pt ICER (5 years): €17,918/QALY for rifaximin + lactulose vs. lactulose |
| UK [55] | Overt HEa | Cost analysis of rifaximin | Mean annual emergency inpatient admission costs, 1 year before vs. 1 year after rifaximin: ₤12,522 vs. ₤5915, respectively (2013/2014 costs) |
| UK [58] | Recurrent overt HE | ICER, derived from QALY Markov state transition model |
Lactulose (SOC) Average cost (2012): ₤23,545 1.83 QALY/pt Rifaximin Average cost: ₤22,971 2.36 QALY/pt ICER 5 years: ₤1083/QALY for rifaximin vs. lactulose 10 years: ₤4470/QALY for rifaximin vs. lactulose Lifetime: ₤7215/QALY for rifaximin vs. lactulose |
| USA [62] | Recurrent overt HE | Costs (drug costs, hospitalizations, liver transplant) Outcomes (hospitalizations, LY, QALY) |
Rifaximin + lactulose vs. lactulose Life expectancy improved with rifaximin + lactulose vs. lactulose (lifetime, 5.7 vs. 2.8 years) Opportunity for liver transplant improved 2-fold with rifaximin + lactulose vs. lactulose Hospitalizations were decreased with rifaximin + lactulose vs. lactulose over 6 mo (0.27/pt vs. 0.51/pt) Lifetime cost of rifaximin: $US 59,777 $US 20,287/LY for rifaximin + lactulose vs. lactulose $US 26,672/QALY for rifaximin + lactulose vs. lactulose |
HE hepatic encephalopathy, ICER incremental cost-effectiveness ratio, LY life-years, QALY quality-adjusted life years, SOC standard of care
aIn this study, costs were compared before and after initiation of rifaximin