Cost-effectiveness analysis of using innovative therapies for the management of moderate-to-severe ulcerative colitis in Spain
Taxonera, Carlos ; de Andrés-Nogales, Fernando ; García-López, Santiago (Universidad de Zaragoza) ; Sánchez-Guerrero, Amelia ; Menchén, Belén ; Peral, Carmen ; Cábez, Ana ; Gómez, Susana ; López-Ibáñez de Aldecoa, Alejandra ; Casado, Miguel Ángel ; Menchén, Luis
Resumen: Background: To evaluate the cost-effectiveness of tofacitinib in comparison to vedolizumab for the treatment of moderate-to-severe ulcerative colitis (UC) after failure or intolerance to conventional therapy (bio-naive) or first-line biologic treatment (bio-experienced), from the Spanish National Health System (NHS) perspective.
Methods: A lifetime Markov model with eight-week cycles was developed including five health states: remission, response, active UC, remission after surgery, and death. Response and remission probabilities (for induction and maintenance periods) were obtained from a multinomial network meta-analysis. Drug acquisition – biosimilar prices included – (ex-factory price with mandatory deductions), adminis- tration, surgery, patient management, and adverse event management costs (€, year 2019) were considered. A 3% discount rate (cost/outcomes) was applied. Probabilistic and deterministic sensitivity analyses (PSA) were conducted.
Results: Tofacitinib was dominant versus vedolizumab (both in bio-naive and bio-experienced patients) entailing total cost savings of €23,816 (bio-naïve) and €11,438 (bio-experienced). Differences in quality- adjusted life-year (QALY) were smaller than 0.1 for both populations. PSA results showed that tofacitinib has a high probability of being cost-effective (bio-naïve: 82.5%; bio-experienced: 90.6%) versus vedolizumab.
Conclusions: From the Spanish NHS perspective, tofacitinib could be a dominant treatment (less costly and more effective) in comparison to vedolizumab, with relevant cost savings and similar QALY gains.
Idioma: Inglés
DOI: 10.1080/14737167.2021.1880324
Año: 2022
Publicado en: Expert Review of Pharmacoeconomics and Outcomes Research 22, 1 (2022), 73-83
ISSN: 1473-7167
Factor impacto JCR: 2.3 (2022)
Categ. JCR: HEALTH CARE SCIENCES & SERVICES rank: 72 / 106 = 0.679 (2022) - Q3 - T3
Categ. JCR: HEALTH POLICY & SERVICES rank: 59 / 87 = 0.678 (2022) - Q3 - T3
Categ. JCR: PHARMACOLOGY & PHARMACY rank: 200 / 278 = 0.719 (2022) - Q3 - T3
Factor impacto CITESCORE: 3.4 - Medicine (Q2)
Factor impacto SCIMAGO: 0.596 - Health Policy (Q2) - Pharmacology (medical) (Q2) - Medicine (miscellaneous) (Q2)
Tipo y forma: Article (Published version)
Área (Departamento): Area Medicina (Dpto. Medicina, Psiqu. y Derm.)
You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. You may not use the material for commercial purposes. If you remix, transform, or build upon the material, you may not distribute the modified material.
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Methods: A lifetime Markov model with eight-week cycles was developed including five health states: remission, response, active UC, remission after surgery, and death. Response and remission probabilities (for induction and maintenance periods) were obtained from a multinomial network meta-analysis. Drug acquisition – biosimilar prices included – (ex-factory price with mandatory deductions), adminis- tration, surgery, patient management, and adverse event management costs (€, year 2019) were considered. A 3% discount rate (cost/outcomes) was applied. Probabilistic and deterministic sensitivity analyses (PSA) were conducted.
Results: Tofacitinib was dominant versus vedolizumab (both in bio-naive and bio-experienced patients) entailing total cost savings of €23,816 (bio-naïve) and €11,438 (bio-experienced). Differences in quality- adjusted life-year (QALY) were smaller than 0.1 for both populations. PSA results showed that tofacitinib has a high probability of being cost-effective (bio-naïve: 82.5%; bio-experienced: 90.6%) versus vedolizumab.
Conclusions: From the Spanish NHS perspective, tofacitinib could be a dominant treatment (less costly and more effective) in comparison to vedolizumab, with relevant cost savings and similar QALY gains.
Idioma: Inglés
DOI: 10.1080/14737167.2021.1880324
Año: 2022
Publicado en: Expert Review of Pharmacoeconomics and Outcomes Research 22, 1 (2022), 73-83
ISSN: 1473-7167
Factor impacto JCR: 2.3 (2022)
Categ. JCR: HEALTH CARE SCIENCES & SERVICES rank: 72 / 106 = 0.679 (2022) - Q3 - T3
Categ. JCR: HEALTH POLICY & SERVICES rank: 59 / 87 = 0.678 (2022) - Q3 - T3
Categ. JCR: PHARMACOLOGY & PHARMACY rank: 200 / 278 = 0.719 (2022) - Q3 - T3
Factor impacto CITESCORE: 3.4 - Medicine (Q2)
Factor impacto SCIMAGO: 0.596 - Health Policy (Q2) - Pharmacology (medical) (Q2) - Medicine (miscellaneous) (Q2)
Tipo y forma: Article (Published version)
Área (Departamento): Area Medicina (Dpto. Medicina, Psiqu. y Derm.)
You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. You may not use the material for commercial purposes. If you remix, transform, or build upon the material, you may not distribute the modified material. Exportado de SIDERAL (2024-03-18-12:41:04)
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Record created 2021-03-09, last modified 2024-03-19