Evidence map›Paper›PMID 34690933›Full record

ArticleFrontiers in endocrinology2021

Cost-Utility of Acromegaly Pharmacological Treatments in a French Context.

Thierry Brue, Philippe Chanson, Patrice Rodien, Brigitte Delemer, Delphine Drui, Lucile Marié, Laurène Juban, Lara Salvi, Robin Henocque, Gérald Raverot

Open access · goldAbstract readNetwork Meta-Analysis
In one paragraph

Article in Frontiers in endocrinology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.0field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 10 citations in OpenAlex.

  1. Trial
  2. Article
  3. Article
  4. Acromegaly: diagnostic challenges and individualized treatment.Expert review of endocrinology & metabolism · 2025
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 7 institutions in 1 country.

Thierry BrueAssistance Publique-Hôpitaux de Marseille (AP-HM), Department of Endocrinology, Hôpital de la Conception, Centre de Référence des Maladies Rares de l'hypophyse HYPO, Marseille, France.
Philippe ChansonUniversité Paris-Saclay, Inserm, Physiologie et Physiopathologie Endocriniennes, Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, Service d'Endocrinologie et des Maladies de la Reproduction, Centre de Référence des Maladies Rares de l'Hypophyse, Le Kremlin-Bicêtre, France.
Patrice RodienUniversité d'Angers, CHU d'Angers, service d'Endocrinologie-Diabétologie-Nutrition, Centre de Référence des Maladies Rares de l'Hypophyse, Angers, France.
Brigitte DelemerCHU de Reims - Hôpital Robert Debré, Service d'Endocrinologie - Diabète - Nutrition, Reims Cedex, France.
Delphine DruiEndocrinology Department, L'institut du thorax, University Hospital of Nantes, Nantes Cedex, France.
Lucile MariéStève Consultants, Paris, France.
Laurène JubanStève Consultants, Paris, France.
Lara SalviRare Disease, Pfizer France, Paris Cedex, France.
Robin HenocqueStève Consultants, Paris, France.
Gérald RaverotEndocrinology Department, "Groupement Hospitalier Est" Hospices Civils de Lyon, Bron, France.
Bicêtre Hospital · FRCentre Hospitalier Le Vinatier · FRCentre Hospitalier Universitaire de Nantes · FRInserm · FRPfizer (France) · FRUniversité d'Angers · FRUniversité de Reims Champagne-Ardenne · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: Efficacy of pharmacological treatments for acromegaly has been assessed in many clinical or real-world studies but no study was interested in economics evaluation of these treatments in France. Therefore, the objective of this study was to estimate the cost-utility of second-line pharmacological treatments in acromegaly patients. Methods: A Markov model was developed to follow a cohort of 1,000 patients for a lifetime horizon. First-generation somatostatin analogues (FGSA), pegvisomant, pasireotide and pegvisomant combined with FGSA (off label) were compared. Efficacy was defined as the normalization of insulin-like growth factor-1 (IGF-1) concentration and was obtained from pivotal trials and adjusted by a network meta-analysis. Costs data were obtained from French databases and literature. Utilities from the literature were used to estimate quality-adjusted life year (QALY). Results: The incremental cost-utility ratios (ICUR) of treatments compared to FGSA were estimated to be 562,463 € per QALY gained for pasireotide, 171,332 € per QALY gained for pegvisomant, and 186,242 € per QALY gained for pegvisomant + FGSA. Pasireotide seems to be the least cost-efficient treatment. Sensitivity analyses showed the robustness of the results. Conclusion: FGSA, pegvisomant and pegvisomant + FGSA were on the cost-effective frontier, therefore, depending on the willingness-to-pay for an additional QALY, they are the most cost-effective treatments. This medico-economic analysis highlighted the consistency of the efficiency results with the efficacy results assessed in the pivotal trials. However, most recent treatment guidelines recommend an individualized treatment strategy based on the patient and disease profile.

Indexed as

Drug CostsAcromegalyAgedAged, 80 and overCohort StudiesCost-Benefit AnalysisDrug Therapy, CombinationFemaleFranceHuman Growth HormoneHumansMaleMarkov ChainsMiddle AgedOctreotideQuality-Adjusted Life YearsHuman Growth HormoneOctreotidepasireotidepegvisomantSomatostatinacromegalycost-utilitygrowth hormoneinsulin-like growth factor-1pasireotidepegvisomantQALYsomatostatin

Identifiers

PMID34690933
PMCPMC8531881
OpenAlexW3206000113

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.