ArticlePloS one2022
Model-based cost-effectiveness analyses comparing combinations of urate lowering therapy and anti-inflammatory treatment in gout patients.
Article in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 10 citations in OpenAlex.
- Cost-Effectiveness of Low-Dose Colchicine Prophylaxis When Starting Allopurinol Using the "Start-Low Go-Slow" Approach for Gout: Evidence From a Noninferiority Randomized Double-Blind Placebo-Controlled Trial.Arthritis care & research · 2026Trial
- Advances in the management of gout: From current strategies to emerging therapies.The Journal of international medical research · 2026Review
- 900 patients evaluated within a median of 1 day from referral in a very early arthritis clinic in France.Rheumatology advances in practice · 2026Article
- Advances in the use of nanotechnology for treating gout.Nanomedicine (London, England) · 2025Review
- Pipeline Therapies for Gout.Current rheumatology reports · 2024Review
- Recent advances in the therapeutic management of calcium pyrophosphate deposition disease.Frontiers in medicine · 2024Review
- Course and predictors of work productivity in gout - results from the NOR-Gout longitudinal 2-year treat-to-target study.Rheumatology (Oxford, England) · 2023Article
- Review
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo assess the cost-effectiveness of various combinations of urate lowering therapy (ULT) and anti-inflammatory treatment in the management of newly diagnosed gout patients, from the Dutch societal perspective.
methodsA probabilistic patient-level simulation estimating costs and quality-adjusted life years (QALYs) comparing gout and hyperuricemia treatment strategies was performed. ULT options febuxostat, allopurinol and no ULT were considered. Flare treatments naproxen, colchicine, prednisone, and anakinra were considered. A Markov Model was constructed to simulate gout disease. Health states were no flare, and severe pain, mild pain, moderate pain, or no pain in the presence of a flare. Model input was derived from patient level clinical trial data, meta-analyses or from previously published health-economic evaluations. The results of probabilistic sensitivity analyses were presented using incremental cost-effectiveness ratios (ICERs), and summarized using cost-effectiveness acceptability curves (CEACs). Scenario analyses were performed.
resultsThe ICER for allopurinol versus no ULT was €1,381, when combined with naproxen. Febuxostat yielded the highest utility, but also the highest costs (€4,385 vs. €4,063 for allopurinol), resulting in an ICER of €25,173 when compared to allopurinol. No ULT was not cost-effective, yielding the lowest utility. For the gout flare medications, comparable effects on utility were achieved. Combined with febuxostat, naproxen was the cheapest option (€4,404), and anakinra the most expensive (€4,651). The ICER of anakinra compared to naproxen was €818,504. Colchicine and prednisone were dominated by naproxen.
conclusionAllopurinol and febuxostat were both cost-effective compared to No ULT. Febuxostat was cost-effective in comparison with allopurinol at higher willingness-to-pay thresholds. For treating gout flares, colchicine, naproxen and prednisone offered comparable health economic implications, although naproxen was the favoured option.
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