Original Title: Pirfenidona en fibrosis pulmonar

Authors' recommendations: CONCLUSIONS Moderate-quality evidence suggests that pirfenidone reduces mortality compared with placebo in patients with mild or moderate idiopathic pulmonary fibrosis after 52 weeks, and probably after 72 weeks, and there are no differences in mortality when compared with nintedanib after 52 weeks. Also, pirfenidone was superior to placebo in several respiratory outcomes (change in forced vital capacity-vital capacity, change in predicted forced vital capacity-vital capacity and in reducing greater or equal to 10% of the predicted forced vital capacity-vital capacity) after 52 weeks. Very low-quality evidence does not allow drawing conclusions about the benefit of pirfenidone when compared with placebo in patients with non-idiopathic pulmonary fibrosis or associated to other diseases (Hermansky-Pudlak syndrome, systemic scleroderma associated to interstitial lung disease, vascular collagen disease, non-specific fibrotic interstitial pneumonia, chronic pneumonitis due to hypersensitivity and asbestos-related pulmonary fibrosis. No economic evaluation or budget impact analysis have been found in Argentina. Even though its retail price is high, the cost of treatment is lower than that of nintedanib, a drug with similar efficacy. Economic evaluations from high-income countries suggest that pirfenidone therapy would not be a cost-effective option in patients with idiopathic pulmonary fibrosis. The United Kingdom maintains a confidential agreement with the pharmaceutical industry on the list price, to be able to provide coverage. The identified clinical practice guidelines recommend treatment with pirfenidone or nintedanib as valid options in patients with idiopathic pulmonary fibrosis. In Argentina, the Superintendence of Healthcare Services does not include pirfenidone for the indication assessed in the Mandatory Medical Plan (Plan Médico Obligatorio) and it is not reimbursed by the Unique Reimbursement System (Sistema Único de Reintegro) either. One Latin-American country and five high-income countries cover pirfenidone in idiopathic pulmonary fibrosis. Brazil expressly does not recommend covering pirfenidone in idiopathic pulmonary fibrosis.

Project Status: Completed

Year Published: 2019

URL for published report: https://www.iecs.org.ar/home-ets/

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Argentina

Organisation Name: Institute for Clinical Effectiveness and Health Policy

Contact Address: Dr. Emilio Ravignani 2024, Buenos Aires - Argentina, C1414 CABA

Contact Name: info@iecs.org.ar

Contact Email: info@iecs.org.ar

Copyright: <p>Institute for Clinical Effectiveness and Health Policy (IECS)</p>