Cost-Effectiveness of Golimumab in Ankylosing Spondylitis from the UK Payer Perspective.

ABSTRACT:

Introduction

Golimumab is a tumor necrosis factor-? (TNF-?) inhibitor for treatment of patients with severe, active ankylosing spondylitis. This study evaluated the cost-effectiveness of golimumab compared with conventional care and other TNF-? inhibitors in treatment of AS from the UK National Health Service perspective.

Methods

A long-term Markov model (with initial decision tree) was developed to simulate the progression of a hypothetical cohort of patients with active AS over a lifetime. The effectiveness outcome was quality-adjusted life-years (QALYs). Utilities were estimated by mapping Bath Ankylosing Spondylitis Functional Index scores, and the primary response measure was ?50% improvement on the Bath Ankylosing Spondylitis Disease Activity Index at 12 weeks. Direct, medication, and AS management costs were included. Costs and outcomes were discounted at 3.5%.

Results

All TNF-? inhibitors were comparable to each other and superior to conventional care. The incremental cost-effectiveness ratios (ICERs) for TNF-? inhibitors were £19,070-42,532 per QALY gained compared with conventional care. Analyses of the ICERs for each TNF-? inhibitor compared with conventional care demonstrated that golimumab was the most cost-effective treatment, and that adalimumab and etanercept were dominated by golimumab. Sensitivity analyses confirmed the robustness of these analyses.

Conclusions

Golimumab may be considered a cost-effective treatment alternative for patients with active AS. With comparable costs and efficacy among TNF-? inhibitors, the choice of TNF-? inhibitor to treat AS is likely to be driven by patient and physician choice.

Funding

Merck & Co., Inc.

SUBMITTER: Borse RH 

PROVIDER: S-EPMC5696295 | biostudies-literature | 2017 Dec

REPOSITORIES: biostudies-literature