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.)