Dataset Information

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

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Publications

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

Borse Rebekah H RH Brown Chloe C Muszbek Noemi N Chaudhary Mohammad Ashraf MA Kachroo Sumesh S

Rheumatology and therapy 20170927 2

<h4>Introduction</h4>Golimumab is a tumor necrosis factor-α (TNF-α) 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-α inhibitors in treatment of AS from the UK National Health Service perspective.<h4>Methods</h4>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 ...[more]

PMID: 28956301

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Project description:ObjectiveThere are no publications that have demonstrated economic value for ankylosing spondylitis (AS) treatments in Indonesia. Cost per responder (CPR) is a lean method of economic evaluation. We estimated CPR from Indonesia's health system perspective following AS treatment with secukinumab relative to adalimumab, golimumab, and infliximab.MethodsIn the absence of head-to-head trials, a comparative evidence analysis was conducted in the form of matching-adjusted indirect comparison (MAIC) to estimate the response rate of various competing treatment options against secukinumab. This was followed by a CPR analysis that compared the cost per patient for a defined response level.ResultsBased on MAIC, patients on secukinumab had higher Assessment in Spondyloarthritis International Society (ASAS) 20 response (improvement of ≥ 20% and ≥ 1 unit in at least three domains on a scale of 10 and no worsening of ≥ 20% and ≥ 1 unit in remaining domain on a scale of 10) and ASAS 40 response (improvement of ≥ 40% and ≥ 2 units in at least three domains on a scale of 10 and no worsening at all in remaining domain) versus those on adalimumab, golimumab, and infliximab at week 24. The cost per ASAS 20 at week 24 for secukinumab was 75% lower than adalimumab, 65% lower than golimumab, and 80% lower than infliximab. The cost per ASAS 40 at week 24 for secukinumab was 77% lower than adalimumab, 67% lower than golimumab, and 83% lower than infliximab. Secukinumab dominated adalimumab, golimumab, and infliximab at week 24 and adalimumab at week 52, by being more efficacious at lower cost. Threshold analysis revealed that substantial reduction in efficacy or increase in cost of secukinumab would make secukinumab not cost effective, indicating the robustness of the results.ConclusionThis study demonstrated that if AS patients in Indonesia were treated with secukinumab instead of comparator therapies, more patients could be treated, and more patients would reach response to treatment for the same budget.

Dataset Information

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

Introduction

Methods

Results

Conclusions

Funding

Publications

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

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