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The following is a summary of “Cost-effectiveness analysis of second-line medical therapies in acromegaly: a real-life study,” published in the April 2025 issue of Frontiers in Endocrinology by Moreno et al. 

Acromegaly a rare condition associated with significant comorbidities and economic burden, highlighting the need for real-world evaluation of second-line treatment costs.  

Researchers conducted a retrospective study to evaluate the use of pasireotide and pegvisomant in a tertiary care center during routine clinical practice.  

They included patients with acromegaly treated with pasireotide and/or pegvisomant in a cross-sectional study (2 years after starting these drugs) to analyze the cost of acromegaly, hormone replacement, type 2 diabetes mellitus (T2DM) treatments and the cost of surgery and radiotherapy; and a cohort study (May 2006—October 2024) to analyze efficacy, safety (adverse events (AEs), fasting glucose, glycated hemoglobin, and T2DM diagnosis), and dose evolution. Descriptive statistics were calculated using 10% trimmed means, standard deviation and 2-tailed hypothesis testing with Yuen’s t and Fisher’s test was applied, with a significance threshold of P < 0.05.  

The results showed that 25 participants were included in the transversal study and 31 in the longitudinal study. A typical patient with a poorly granulated growth hormone (GH)-producing adenoma underwent a single in-center surgery and received radiotherapy. In the transversal study, the total pharmacological cost was €34,139.29 (13,472.09) per person per year, with €33,874.88 (13,468.36) per person per year spent on second-line acromegaly drugs. Pasireotide generated savings of €9,423.26 per person per year (P= .12), reaching €30,415.98 per person per year at high doses (P< 0.001). In the longitudinal study, the pasireotide dose was reduced (P= .06) irrespective of the treatment modality. Pasireotide influenced carbohydrate metabolism (P= .001), although the effect was mild.  

Investigators concluded that pasireotide had been found to be a more cost-effective option for patients in whom first-line treatment had failed. 

Source: frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2025.1573721/full