OBJECTIVES

: Acromegaly is a rare endocrine disease caused by a pituitary adenoma, which subsequently impacts quality of life and leads to more healthcare utilization. In Brazil, there are two somatostatin analogs available in the public healthcare system (SUS). The aim of this study is to conduct a cost-minimization analysis comparing lanreotide autogel (LAN) with octreotide LAR for the treatment of patients with acromegaly who have not responded to surgery, considering Brazilian public system perspective.

METHODS

: A 2-state model was developed considering 3-month cycles and a time horizon of 30 years. After the end of each cycle, patients could transition from alive to dead state considering the mortality rate of the general population. The costs of drugs, nursing/clinical resource use and wastage of drugs were added, a discount rate of 5% per year was applied, and a mean age of 52 (SD 12) years considered. Results are reported as difference in costs between two treatments per patient for a 30-year horizon in absolute and percentage costs.

RESULTS

: LAN estimated treatment costs were R$ 353,558, compared with octreotide LAR R$ 581,218; thus, the overall estimated savings are R$ 227,661 (39%) million for lifelong treatment. The estimated saving with LAN compared with octreotide LAR in terms of drug acquisition cost is R$ 201 (36%) million, nurse/clinic cost is R$ 2,1 million (71%) and wastage cost is up to R$ 25 million (100%), over a lifetime period in the public health system, considering Brazilian population parameters.

CONCLUSIONS

: In this model, the estimated cost of treating patients with acromegaly is less with LAN than with octreotide LAR. Savings are achieved due to lower direct acquisition costs, administration of LAN is faster, which reduces the nursing cost, and because the wastage is minimal as LAN has no risk of clogging, compared with octreotide LAR.