Cost-effectiveness of Viridal Duo compared to MUSE and Viagra in the treatment of erectile dysfunction in the UK - a preliminary model.

Authors: JM Plumb & JF Guest.
Source: Journal of Medical Economics 1999; 2: 65-83.

ABSTRACT

This study estimated the cost-effectiveness of starting erectile dysfunction (ED) treatment with Viridal Duo relative to MUSE and Viagra over one year, from the perspective of the National Health Service. Decision analysis techniques were used to estimate the expected costs and consequences of managing ED, stratified by initial treatment. The model was based on estimates of clinical outcome and resource use obtained from published literature and a Delphi panel.

Starting ED treatment with Viridal Duo instead of Viagra leads to an average 0.8 additional months during which a man can achieve successful erections (from 6.5 to 7.3 months) over one year, for an additional cost of £106 per patient (from £369 to £475). Starting ED treatment with Viagra instead of MUSE leads to an average 1.1 additional months during which a man can achieve successful erections (from 5.4 to 6.5 months) over one year and reduces the cost per patient by £85 (from £454 to £369).

Fifty-two percent of patients who start treatment with Viridal Duo continue successfully over one year. This compares to 38% and 18% of patients who start treatment with Viagra and MUSE respectively. Eighty-seven percent of the total success with Viridal Duo can be directly attributed to this treatment when used first-line. In contrast, 68% and 44% of the total success attributed to Viagra and MUSE respectively can be attributed to these treatments when chosen first-line. Moreover, an additional 44% and 27% of the expected total success with MUSE and Viagra is attributable to Viridal Duo.

Starting ED treatment with Viridal Duo rather than MUSE, when Viagra is either unavailable or contraindicated, increases the period during which a man can achieve successful erections by 1.8 months (from 5.5 to 7.3 months) for an additional cost of £14 per patient (from £460 to £474). Additionally, in patients who have previously failed Viagra, starting second-line treatment with Viridal Duo rather than MUSE leads to an average 1.6 additional months during which a man can achieve successful erections (from 4.0 to 5.6 months) over one year and reduces the cost per patient by £15 (from £493 to £478).

In conclusion, Viridal Duo is clinically more effective than Viagra and MUSE. Therefore, starting ED treatment with Viridal Duo instead of Viagra or MUSE increases the period during which a man can achieve successful erections, albeit for an additional cost. In patients who have previously failed first-line treatment with Viagra, starting second-line treatment with Viridal Duo instead of MUSE increases the period during which a man can achieve successful erections (by 40% at one year) and reduces healthcare costs (by £15 per patient).