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In this article, we review randomized controlled trials, open-label trials and pharmacoeconomic models of bosentan for the management of patients with pulmonary arterial hypertension. Bosentan consistently improves WHO functional class and quality of life, slows clinical worsening and is associated with improved survival compared with historical treatment. Although headto- head trials are scarce, data directly comparing bosentan with sildenafil indicate no clinically significant differences between treatments as measured by the 6-min walk distance alone. Compared with historical care, bosentan treatment, over a 15–30-year period, increases the number of quality-adjusted life years (3.49 years). Economic modeling suggests that the cost–effectiveness of bosentan is similar to that of ambrisentan (US$43,725–57,778 per qualityadjusted life year), not as cost effective as sildenafil (at 20 mg three-times daily) and more cost effective than iloprost. More randomized controlled trials of longer duration are required to confirm the results from these economic models.

Item Type:	Refereed Article
Keywords:	cost-effectiveness; endothelin receptor antagonists; incremental cost-effectiveness ratio; phosphodiesterase inhibitors; pulmonary arterial hypertension; quality-adjusted life years
Research Division:	Medical and Health Sciences
Research Group:	Pharmacology and Pharmaceutical Sciences
Research Field:	Clinical Pharmacy and Pharmacy Practice
Objective Division:	Health
Objective Group:	Health and Support Services
Objective Field:	Evaluation of Health Outcomes
Author:	Dalton, B (Mr Brad Dalton)
ID Code:	78015
Year Published:	2011
Web of Science® Times Cited:	4
Deposited By:	Health Sciences A
Deposited On:	2012-06-12
Last Modified:	2012-08-30
Downloads:	0