Hyponatremia cost-effectiveness of therapy

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Hyponatremia can occur in association with a variety of underlying conditions, like tumors that synthesize and excrete vasopressin ectopically to disorders such as congestive heart failure and cirrhosis where vasopressin secretion from the posterior pituitary is stimulated by decreased effective circulating blood volume. Hospitalizations are longer in hyponatremic patients because they represent a sicker cohort of all patients with any of the above underlying disorders. [1]

Tolvaptan, a vasopressin V2 receptor antagonist for the treatment of SIADH was investigated in Sweden [2] and found to have reduced costs and increased quality-adjusted life-years (QALYs) (0.0019) compared with NAT (no active treatment) and was therefore used as the dominant treatment strategy.

Uss of tolvaptan among hyponatremic EVEREST trial heart failure patients in the US, was associated with shorter hospital LOS (length of stay) than placebo patients (9.72 vs 11.44 days respectively). [3]


References

  1. Boscoe A, Paramore C, Verbalis JG (2006). "Cost of illness of hyponatremia in the United States". Cost Eff Resour Alloc. 4: 10. doi:10.1186/1478-7547-4-10. PMC 1525202. PMID 16737547.
  2. Jamookeeah, Clare; Robinson, Paul; O’Reilly, Karl; Lundberg, Johan; Gisby, Martin; Ländin, Michael; Skov, Jakob; Trueman, David (2016). "Cost-effectiveness of tolvaptan for the treatment of hyponatraemia secondary to syndrome of inappropriate antidiuretic hormone secretion in Sweden". BMC Endocrine Disorders. 16 (1). doi:10.1186/s12902-016-0104-z. ISSN 1472-6823.
  3. Chiong, Jun R.; Kim, Sonnie; Lin, Jay; Christian, Rudell; Dasta, Joseph F. (2011). "Evaluation of costs associated with tolvaptan-mediated length-of-stay reduction among heart failure patients with hyponatremia in the US, based on the EVEREST trial". Journal of Medical Economics. 15 (2): 276–284. doi:10.3111/13696998.2011.643329. ISSN 1369-6998.

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