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4.3.1 Sintesi e raccomandazioni - Biblioteca Medica

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In conclusione i risultati di questa valutazione mostrano come il rapporto costo efficacia<br />

della combinazione sia comunque decisamente elevato se confrontato con i valori di accettabilità<br />

definiti a livello internazionale (p. es. un costo di $30.000 per anno di vita salvato [15]).<br />

Quindi, tenendo conto dell’attuale prezzo dei farmaci, la terapia combinata pare non avere<br />

una compatibilità economica accettabile per il nostro SSN, se non per specifici pazienti<br />

selezionati, cioè quelli ad alto rischio di progressione. Qualora in futuro si rendessero disponibili<br />

i dati dell’impatto della combinazione 5ARI e α 1<br />

-litici sulla qualità di vita dei pazienti,<br />

l’analisi dovrebbe essere rivista tenendo conto di questi risultati.<br />

6.2.5.2. Bibliografia<br />

1. Johnson NJ, Kirby RS. Treatments for benign prostatic hyperplasia: An analysis of their<br />

clinical and economic impact in the United Kingdom and Italy. J Outcomes Res, 1999:<br />

3, 11-26.<br />

2. Lowe FC, McDaniel RL, Chmiel JJ, Hillman AL. Economic modeling to assess the costs of<br />

treatment with finasteride, terazosin, and transurethral resection of the prostate for men<br />

with moderate to severe symptoms of benign prostatic hyperplasia. Urology, 1995: 46,<br />

477-483.<br />

3. Cockrum PC, Finder SF, Ries AJ, Potyk RP. A pharmacoeconomic analysis of patients with<br />

symptoms of benign prostatic hyperplasia. Pharmacoeconomics, 1997: 11, 550-565.<br />

4. McConnell JD, Barry MJ, Bruskewitz RC et al Benign prostatic hyperplasia: diagnosis and<br />

treatment. Agency for Health Care Policy and Research. Clin Pract Guide/Quick Ref<br />

Guide Clin 1994 AHCPR Publication N 94-0582<br />

5. Albertsen PC, Pellissier JM, Lowe FC, Girman CJ, Roehrborn CG. Economic analysis of<br />

finasteride: A model-based approach using data from the Proscar long-term efficacy<br />

and safety study. Clin Ther, 1999: 21, 1006-1024<br />

6. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting<br />

enzyme inhibitor or calcium channel blocker vs diuretic: The Antihypertensive and<br />

Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA, 2002:<br />

288, 2981-97<br />

7. Hillman AL, Schwartz JS, Willian MK, Peskin E, Roehrborn CG, Oesterling JE, Mason<br />

MF, Maurath CJ, Deverka PA, Padley RJ. The cost-effectiveness of terazosin and placebo<br />

in the treatment of moderate to severe benign prostatic hyperplasia. Urology, 1996:<br />

47, 169-178<br />

8. Lanes SF, Sulsky S, Walker AM et al A cost density analysis of benign prostatic hyperplasia<br />

Clin Ther, 1996: 18, 993-1004<br />

9. Oster G, Edelsberg J, Pozniak A, Thompson D. Resource utilisation and costs of treatment<br />

with doxazosin versus tamsulosin in men with benign prostatic hyperplasia. J Outcomes<br />

Res, 2000: 4, 31-40.<br />

10. Baladi JF, Menon D, Otten N. An economic evaluation of finasteride for treatment of<br />

benign prostatic hyperplasia. Pharmacoeconomics, 1996: 9, 443-454<br />

179

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