No cost effectiveness studies were identified.
According to the Drug Tariff (September 2013), 180 colesevelam tablets (625 mg) cost £87.36. A dosage of 6 tablets (3.75 g) daily in divided doses was used in Odunsi-Shiyanbade et al. (2010) and Wedlake et al. (2009). In Puleston et al. (2005) dosages ranged between 2 and 6 tablets (1.25−3.75 g) per day. Current costs for 1.25 g colesevelam per day are £0.97, and for 3.75 g per day £2.91.
According to the Drug Tariff (September 2013), 50 colestyramine 4 g oral powder sachets cost £10.76. The cost of 50 sugar-free sachets is £28.10. The summary of product characteristic for Questran states that the usual dosage of colestyramine for the relief of diarrhoea is 3 to 6 sachets (12−24 g) daily. This dosage currently costs between £0.65 and £1.29 per day for standard sachets, and £1.69 and £3.37 for sugar-free sachets.
According to MIMS (September 2013), 30 colestipol 5 g sachets cost £15.05. It is unclear what dose should be used for bile acid malabsorption because this is an unlicensed indication. The summary of product characteristics for Colestid states that the daily dose of colestipol for hypercholesterolaemia is 1 to 6 sachets (5−30 g). This dose currently costs between £0.50 and £3.01 per day.
NHS prescription cost analysis for England, 2012 reported that 21,200 prescriptions for colesevelam were dispensed in primary care in England in 2012 at a net cost of £1,534,800. It is not known for which indications colesevelam was prescribed, but most of the prescriptions are likely to have been for hypercholesterolaemia.
No estimate of the use of colesevelam for bile acid malabsorption in UK clinical practice was available at the time this evidence summary was prepared.