Cost-effectiveness analysis of baclofen and chlordiazepoxide in uncomplicated
alcohol-withdrawal syndrome.
Author(s): Reddy VK(1), Girish K(1), Lakshmi P(2), Vijendra R(1), Kumar A(2), Harsha R(1).
Affiliation(s): Author information:
(1)Department of Pharmacology, Kempegowda Institute of Medical Sciences,
Bangalore, Karnataka, India. (2)Department of Psychiatry, Kempegowda Institute of
Medical Sciences, Bangalore, Karnataka, India.
Publication date & source: 2014, Indian J Pharmacol. , 46(4):372-7
OBJECTIVES: Benzodiazepines (BZDs) are the first-line drugs in alcohol-withdrawal
syndrome (AWS). Baclofen, a gamma-aminobutyric acidB (GABAB) agonist, controls
withdrawal symptoms without causing significant adverse effects. The objective of
this study was to compare the cost-effectiveness of baclofen and chlordiazepoxide
in the management of uncomplicated AWS.
MATERIALS AND METHODS: This was a randomized, open label, standard controlled,
parallel group study of cost-effectiveness analysis (CEA) of baclofen and
chlordiazepoxide in 60 participants with uncomplicated AWS. Clinical efficacy was
measured by the Clinical Institute Withdrawal Assessment for alcohol (CIWA-Ar)
scores. Lorazepam was used as supplement medication if withdrawal symptoms could
not be controlled effectively by the study drugs alone. Both direct and indirect
medical costs were considered and the CEA was analyzed in both patient's
perspective and third-party perspective.
RESULTS: The average cost-effectiveness ratio (ACER) in patient's perspective of
baclofen and chlordiazepoxide was Rs. 5,308.61 and Rs. 2,951.95 per symptom-free
day, respectively. The ACER in third-party perspective of baclofen and
chlordiazepoxide was Rs. 895.01 and Rs. 476.29 per symptom-free day,
respectively. Participants on chlordiazepoxide had more number of symptom-free
days when compared with the baclofen group on analysis by Mann-Whitney test (U =
253.50, P = 0.03).
CONCLUSION: Both study drugs provided relief of withdrawal symptoms.
Chlordiazepoxide was more cost-effective than baclofen. Baclofen was relatively
less effective and more expensive than chlordiazepoxide.
|