The cost‐effectiveness of macrogol 3350 compared to lactulose in the treatment of adults suffering from chronic constipation in the UK

Background  It is unknown whether macrogol 3350 (Movicol) affords the UK’s National Health Service (NHS) a cost‐effective addition to the current range of laxatives. Aim  To estimate the cost‐effectiveness of macrogol 3350 compared with lactulose in the treatment of chronic constipation, from the pe...

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Bibliographic Details
Published in:Alimentary pharmacology & therapeutics 2010-01, Vol.31 (2), p.302-312
Main Authors: TAYLOR, R. R., GUEST, J. F.
Format: Article
Language:English
Subjects:
Adult
Aged
Chronic Disease
Constipation - drug therapy
Constipation - economics
Cost-Benefit Analysis
Female
Humans
Lactulose - economics
Lactulose - therapeutic use
Laxatives - economics
Laxatives - therapeutic use
Male
Middle Aged
Models, Economic
National Health Programs - economics
Polyethylene Glycols - therapeutic use
Quality of Life
Treatment Outcome
United Kingdom
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Summary:Background  It is unknown whether macrogol 3350 (Movicol) affords the UK’s National Health Service (NHS) a cost‐effective addition to the current range of laxatives. Aim  To estimate the cost‐effectiveness of macrogol 3350 compared with lactulose in the treatment of chronic constipation, from the perspective of the UK’s NHS. Methods  A decision model depicting the management of chronic constipation was constructed using clinical outcomes and resource use values derived from patients suffering from chronic constipation in The Health Independent Network (THIN) database. The model was used to estimate the cost‐effectiveness of a GP prescribing macrogol 3350 instead of lactulose to treat adults ≥18 years of age suffering from chronic constipation. Results  Sixty‐eight percent of patients given macrogol 3350 were successfully treated within 6 months after starting treatment compared to 60% of patients given lactulose.Patients’ health status at 6 months was estimated to be 0.458 and 0.454 quality‐adjusted life years (QALYs) in the macrogol 3350 and lactulose groups respectively. The total 6‐monthly NHS cost of initially treating patients with macrogol 3350 or lactulose was estimated to be £420 (US $688) and £419 (US $686) respectively. Hence, the cost per QALY gained with macrogol 3350 was estimated to be £250 (US $410). Conclusion  Macrogol 3350 affords the NHS a cost‐effective addition to the range of laxatives available for this potentially resource‐intensive condition. Aliment Pharmacol Ther 31, 302–312
ISSN:0269-2813
1365-2036
DOI:10.1111/j.1365-2036.2009.04191.x