ArticleJournal of gastroenterology2026
Cost-utility analysis of treatment strategies for chronic constipation in Japan.
Article in Journal of gastroenterology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Authors and funding
4 authors.
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Abstract
backgroundChronic constipation reduces quality of life and imposes a significant economic burden. The introduction of novel agents in Japan has expanded treatment options. This study aimed to establish a cost-effective treatment strategy, considering clinical utility and patient satisfaction.
methodsNine treatment strategies were developed, each consisting of three consecutive treatment options selected from five drugs: magnesium oxide (MgO), lubiprostone, linaclotide, elobixibat, and PEG formulation. A Markov state-transition model was used to estimate costs and outcomes. Effectiveness data were derived from a network meta-analysis of spontaneous bowel movements within 24 h (SBM24) using domestic trial data. Expected costs and quality-adjusted life years (QALYs) were calculated from the healthcare payer's perspective.
resultsIn the network meta-analysis, lubiprostone had the highest relative risk for SBM24 (2.36), followed by lactulose (1.84) and elobixibat (1.71). Compared to MgO, the lubiprostone-elobixibat-PEG formulation strategy had additional costs of JPY 8,069.5 and a QALY gain of 0.0710, resulting in an incremental cost-effectiveness ratio (ICER) of JPY 113,709/QALY-well below the willingness-to-pay threshold of JPY 5-6 million/QALY. All strategies had ICERs below JPY 200,000/QALY, indicating favorable cost-effectiveness. Sensitivity analyses confirmed that the lubiprostone-elobixibat-PEG formulation strategy remained the most cost-effective, demonstrating its robustness.
conclusionsThe lubiprostone-elobixibat-PEG formulation strategy showed the most favorable cost-effectiveness profile. In addition, novel treatment options, including lubiprostone, linaclotide, elobixibat, and PEG formulation, were found to be cost-effective compared to MgO. Further research is warranted to confirm these findings and support their application in clinical practice.
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