Economic and pharmaco-economic analysis of acromegaly treatment: a systematic review

Acromegaly is a rare disease with significant social and economic burden considering both main treatment patterns and concomitant diseases. The aim of this study was to present a systematic overview of the economic and pharmaco-economic studies of acromegaly treatment. A systematic search in PubMed and Google Scholar was performed following the validated five-step approach for preparing a systematic review of economic evaluations for informing evidence-based healthcare decision on the basis of predefined inclusion and exclusion criteria. To perform critical analysis of the selected articles, the costs on macrolevel and microlevel were extracted and inflated to 2018 for the purposes of their comparison. Of 100 studies, 33 ones were included in the present analysis, most of them being cost-of-illness studies (12), followed by cost-effectiveness analysis applying Markov modeling or decision tree models (9). The total costs for acromegaly patients in different countries as a percent of the gross domestic product (GDP) vary in the range between 0.00001% and 0.003%. The annual direct and indirect costs per patient vary in the range between 3,788 ? and 93,970 ? as a result of differences in the type of calculations. Acromegaly is a high-consuming rare disease, so it is urgent to provide economically based evidence in every country for the purposes of making the most suitable policy decisions in the healthcare sector.