Cost-utility of biological treatment sequences for luminal Crohn's disease in Europe
Jazyk angličtina Země Velká Británie, Anglie Médium print-electronic
Typ dokumentu srovnávací studie, časopisecké články
- Klíčová slova
- Adalimumab, Crohn’s disease, biosimilar infliximab, cost-effectiveness, inflammatory bowel diseases, infliximab, vedolizumab,
- MeSH
- adalimumab aplikace a dávkování ekonomika terapeutické užití MeSH
- analýza nákladů a výnosů MeSH
- biosimilární léčivé přípravky aplikace a dávkování ekonomika terapeutické užití MeSH
- Crohnova nemoc farmakoterapie ekonomika MeSH
- ekonomické modely MeSH
- gastrointestinální látky aplikace a dávkování ekonomika terapeutické užití MeSH
- humanizované monoklonální protilátky aplikace a dávkování ekonomika terapeutické užití MeSH
- infliximab aplikace a dávkování ekonomika terapeutické užití MeSH
- kombinovaná farmakoterapie MeSH
- kvalitativně upravené roky života MeSH
- lidé MeSH
- Markovovy řetězce MeSH
- randomizované kontrolované studie jako téma MeSH
- rozvrh dávkování léků MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- srovnávací studie MeSH
- Geografické názvy
- Evropa MeSH
- Názvy látek
- adalimumab MeSH
- biosimilární léčivé přípravky MeSH
- gastrointestinální látky MeSH
- humanizované monoklonální protilátky MeSH
- infliximab MeSH
- vedolizumab MeSH Prohlížeč
BACKGROUND: This study aims to compare the cost-effectiveness of treatment sequences with available biologics, including adalimumab (ADA), biosimilar infliximab (bsIFX), originator infliximab (IFX) and vedolizumab (VEDO) for luminal Crohn's disease in nine European countries. METHODS: A Markov-model was constructed to simulate five-year medical costs and quality-adjusted life years (QALYs). Data on clinical efficacy were obtained from randomised controlled trials. Country-specific unit costs, discount rates and a third-party payer perspective were applied. RESULTS: The bsIFX versus conventional therapy resulted in the most favourable incremental cost-utility ratios (ICURs) ranging from €34,580 (Hungary) to €77,062/QALY (Sweden). Compared to bsIFX, the bsIFX-ADA sequence was more cost-effective than the bsIFX-VEDO sequence with ICURs varying between €70,277 (France) and €162,069/QALY (Germany). The ICURs of the bsIFX-ADA-VEDO sequence versus the bsIFX-ADA strategy were between €206,266 (The Netherlands) and €363,232/QALY (Spain). CONCLUSION: We are the first to compare cost-effectiveness of multiple biological sequences for luminal Crohn's disease. Based on our findings, bsIFX can be recommended as a first-line treatment in patients unresponsive to conventional treatments. While biological sequences only slightly differ in their associated health gains, their costs vary greatly. The bsIFX-ADA-VEDO seems to be the most cost-effective sequence of the available biologics across Europe.
b 1st Department of Medicine Semmelweis University Budapest Hungary
c Department of Medicine 1 Agaplesion Markus Krankenhaus Frankfurt Germany
Department of Gastroenterology Faculty of Medicine and Health Örebro University Örebro Sweden
Department of Health Economics Corvinus University of Budapest Budapest Hungary
e Gastroenterology Unit Clinical Universitary Hospital Lozano IIS Aragón Zaragoza Spain
Citace poskytuje Crossref.org
Biosimilars: concept, current status, and future perspectives in inflammatory bowel diseases
