Cost-effectiveness analysis of using innovative therapies for the management of moderate-to-severe ulcerative colitis in Spain
Open Access
- 20 February 2021
- journal article
- research article
- Published by Informa UK Limited in Expert Review of Pharmacoeconomics & Outcomes Research
- Vol. 22 (1), 73-83
- https://doi.org/10.1080/14737167.2021.1880324
Abstract
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. 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), administration, 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. 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. 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.Keywords
Funding Information
- Pfizer S.L.U
This publication has 37 references indexed in Scilit:
- Low-dose Infliximab for Induction and Maintenance Treatment in Chinese Patients With Moderate to Severe Active Ulcerative ColitisJournal of Clinical Gastroenterology, 2015
- Which patients with inflammatory bowel disease should receive combination therapy?Expert Review of Gastroenterology & Hepatology, 2015
- Combination Therapy With Infliximab and Azathioprine Is Superior to Monotherapy With Either Agent in Ulcerative ColitisGastroenterology, 2014
- Vedolizumab as Induction and Maintenance Therapy for Ulcerative ColitisNew England Journal of Medicine, 2013
- State-Transition Modeling: A Report of the ISPOR-SMDM Modeling Good Research Practices Task Force-3Value in Health, 2012
- Modeling Good Research Practices—Overview: A Report of the ISPOR-SMDM Modeling Good Research Practices Task Force-1Value in Health, 2012
- Systematic review: the costs of ulcerative colitis in Western countriesAlimentary Pharmacology & Therapeutics, 2010
- Cost-utility analysis of infliximab and adalimumab for refractory ulcerative colitisCost Effectiveness and Resource Allocation, 2009
- Do Patient Preferences Influence Decisions on Treatment for Patients With Steroid-Refractory Ulcerative Colitis?Clinical Gastroenterology and Hepatology, 2006
- Infliximab for Induction and Maintenance Therapy for Ulcerative ColitisNew England Journal of Medicine, 2005