Economic analysis of Noqturina® (oral lyophilisate) use in the symptomatic treatment of nocturia due to idiopathic nocturnal polyuria

Abstract

Nocturia relates to the need to urinate at night when micturition was preceded by sleep and immediately followed by a period of sleep. The aim of this analysis is to examine the cost-effectiveness of desmopressin at a dose of 25 μg oral lyophilisate for women and 50 μg oral lyophilisate for men (DDAVP) in comparison to the best supportive care (BSC) used in Polish clinical practice in the treatment of nocturia (≥2 nocturnal micturition) caused by idiopathic nocturnal polyuria. Methods: The economic analysis uses a model combining the aspects of the partitioned-survival model and state-transition model (STM). The projection was carried out over a 30-year time horizon, which corresponds to 120 quarterly modelling cycles. The costs were calculated from a common perspective, including expenses incurred by the public payer (Narodowy Fundusz Zdrowia, National Health Found) and expenses incurred by the patient. Health effects of medical technologies have been estimated on the basis of unit data from CS40 and CS41 studies. The literature, statistical databases and information provided by clinical experts were used to develop the remaining input data, including utility. Results: The ICER for DDAVP + BSC compared to BSC was 56.1 kPLN (13.0 kEUR) and is below the cost-effectiveness threshold in force in Poland (135.5 kPLN; 31.2 kEUR). The multi-directional sensitivity analysis shows a profitability rate of 98.6%. Conclusions: The economic model shows that the addition of orodispersible DDAVP to standard treatment allows reducing the expected number of nocturnal micturition, improving the quality of life and reducing the number of injuries and fractures in the group of patients with nocturia caused by idiopathic nocturnal polyuria. Considering the total direct medical costs of treatment, desmopressin administered at a dose of 25 μg for women and 50 μg for men is a cost-effective therapy when added to the BSC.