COST-EFFECTIVENESS OF L-ORNITHINE L-ASPARTATE THERAPY IN SEVERE HEPATIC ENCEPHALOPATHY

Introduction and Objectives

Hepatic encephalopathy (HE) is a complication of cirrhosis that negatively impacts patients' quality of life and increases healthcare costs. The objective was to evaluate the remission of HE and the reduction of hospital stay with the use of parenteral L-Ornithine L-Aspartate. (LOLA)

Patients and Methods

A cost-effectiveness comparison of treatment with LOLA in hospitalized patients with decompensated cirrhosis was made, considering remission of HE of time as either <3 days or >3 days in patients who survived.

Results

Retrospective, descriptive and analytical study including 52 patients with severe HE decompensated cirrhosis, age 54.25±10.11, 36 men (69%), Child Pugh 10.9±1.9, MELD NA 21.69±7.27. All received parenteral LOLA 20 g continuous infusion. 23 (44.23%) had effective remission, the average cost per patient with effective remission was 1526 MXN, the cost of patients with ineffective remission was 5,130 MXN. The cost-effectiveness adjusted to quality of life at 0.8 was 1907.5 MXN in effective remission and 6,415 MXN in ineffective remission.

The cost difference was MXN 3,604 which is increased in patients with ineffective remission. The difference was statistically significant according to the t-test (1=-4.54; p<0.001).

Conclusions

Treatment with LOLA is significantly more cost-effective for patients who achieve early clinical remission (within three days) and survive. This finding emphasizes the significance of therapeutic strategies that aim to achieve early remissions in HE.

Conflict of interest: None

Cost-effectiveness adjusted for quality of life