Evaluating the Cost-Effectiveness of Early Compared with Late or No Biologic Treatment to Manage Crohn's Disease using Real-World Data.
Details
Serval ID
serval:BIB_FD20E4E2DB98
Type
Article: article from journal or magazin.
Publication sub-type
Minutes: analyse of a published work.
Collection
Publications
Institution
Title
Evaluating the Cost-Effectiveness of Early Compared with Late or No Biologic Treatment to Manage Crohn's Disease using Real-World Data.
Journal
Journal of Crohn's & colitis
Working group(s)
Swiss IBD Cohort Study group
Contributor(s)
Anderegg C., Bauerfeind P., Beglinger C., Begré S., Belli D., Bengoa J.M., Biedermann L., Bigler B., Binek J., Blattmann M., Boehm S., Borovicka J., Braegger C.P., Brunner N., Bühr P., Burnand B., Burri E., Buyse S., Cremer M., Criblez D.H., de Saussure P., Degen L., Delarive J., Doerig C., Dora B., Dorta G., Egger M., Ehmann T., El-Wafa A., Engelmann M., Ezri J., Felley C., Fliegner M., Fournier N., Fraga M., Frei P., Frei R., Fried M., Froehlich F., Funk C., Furlano R.I., Gallot-Lavallée S., Geyer M., Girardin M., Golay D., Grandinetti T., Gysi B., Haack H., Haarer J., Helbling B., Hengstler P., Herzog D., Hess C., Heyland K., Hinterleitner T., Hiroz P., Hirschi C., Hruz P., Iwata R., Jost R., Juillerat P., Keller C., Knellwolf C., Knoblauch C., Köhler H., Koller R., Krieger-Grübel C., Kullak-Ublick G., Künzler P., Landolt M., Lange R., Lehmann F.S., Macpherson A., Maerten P., Maillard M.H., Manser C., Manz M., Marbet U., Marx G., Matter C., Meier R., Mendanova M., Michetti P., Misselwitz B., Morell B., Mosler P., Mottet C., Müller C., Müller P., Müllhaupt B., Münger-Beyeler C., Musso L., Nagy A., Neagu M., Nichita C., Niess J., Nydegger A., Obialo N., Oneta C., Oropesa C., Peter U., Peternac D., Petit L.M., Piccoli-Gfeller F., Pilz J.B., Pittet V., Raschle N., Rentsch R., Restellini S., Richterich J.P., Rihs S., Ritz M.A., Roduit J., Rogler D., Rogler G., Rossel J.B., Rueger V., Saner G., Sauter B., Sawatzki M., Schäppi M., Scharl M., Scharl S., Schelling M., Schibli S., Schlauri H., Uebelhart S.S., Schnegg J.F., Schoepfer A., Seibold F., Seirafi M., Semadeni G.M., Semela D., Senning A., Sidler M., Sokollik C., Spalinger J., Spangenberger H., Stadler P., Steuerwald M., Straumann A., Straumann-Funk B., Sulz M., Suter A., Thorens J., Tiedemann S., Tutuian R., Vavricka S., Viani F., Vögtlin J., Von Känel R., Vonlaufen A., Vouillamoz D., Vulliamy R., Wermuth J., Werner H., Wiesel P., Wiest R., Wylie T., Zeitz J., Zimmermann D.
ISSN
1876-4479 (Electronic)
ISSN-L
1873-9946
Publication state
Published
Issued date
21/05/2020
Peer-reviewed
Oui
Volume
14
Number
4
Pages
490-500
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Publication Status: ppublish
Abstract
We evaluated the cost-effectiveness of early [≤2 years after diagnosis] compared with late or no biologic initiation [starting biologics >2 years after diagnosis or no biologic use] for adults with Crohn's disease in Switzerland.
We developed a Markov cohort model over the patient's lifetime, from the health system and societal perspectives. Transition probabilities, quality of life, and costs were estimated using real-world data. Propensity score matching was used to ensure comparability between patients in the early [intervention] and late/no [comparator] biologic initiation strategies. The incremental cost-effectiveness ratio [ICER] per quality-adjusted life year [QALY] gained is reported in Swiss francs [CHF]. Sensitivity and scenario analyses were performed.
Total costs and QALYs were higher for the intervention [CHF384 607; 16.84 QALYs] compared with the comparator [CHF340 800; 16.75 QALYs] strategy, resulting in high ICERs [health system: CHF887 450 per QALY; societal: CHF449 130 per QALY]. In probabilistic sensitivity analysis, assuming a threshold of CHF100 000 per QALY, the probability that the intervention strategy was cost-effective was 0.1 and 0.25 from the health system and societal perspectives, respectively. In addition, ICERs improved when we assumed a 30% reduction in biologic prices [health system: CHF134 502 per QALY; societal: intervention dominant].
Early biologic use was not cost-effective, considering a threshold of CHF100 000 per QALY compared with late/no biologic use. However, early identification of patients likely to need biologics and future drug price reductions through increased availability of biosimilars may improve the cost-effectiveness of an early treatment approach.
We developed a Markov cohort model over the patient's lifetime, from the health system and societal perspectives. Transition probabilities, quality of life, and costs were estimated using real-world data. Propensity score matching was used to ensure comparability between patients in the early [intervention] and late/no [comparator] biologic initiation strategies. The incremental cost-effectiveness ratio [ICER] per quality-adjusted life year [QALY] gained is reported in Swiss francs [CHF]. Sensitivity and scenario analyses were performed.
Total costs and QALYs were higher for the intervention [CHF384 607; 16.84 QALYs] compared with the comparator [CHF340 800; 16.75 QALYs] strategy, resulting in high ICERs [health system: CHF887 450 per QALY; societal: CHF449 130 per QALY]. In probabilistic sensitivity analysis, assuming a threshold of CHF100 000 per QALY, the probability that the intervention strategy was cost-effective was 0.1 and 0.25 from the health system and societal perspectives, respectively. In addition, ICERs improved when we assumed a 30% reduction in biologic prices [health system: CHF134 502 per QALY; societal: intervention dominant].
Early biologic use was not cost-effective, considering a threshold of CHF100 000 per QALY compared with late/no biologic use. However, early identification of patients likely to need biologics and future drug price reductions through increased availability of biosimilars may improve the cost-effectiveness of an early treatment approach.
Keywords
Adult, Biological Products/economics, Biological Products/therapeutic use, Biosimilar Pharmaceuticals/economics, Biosimilar Pharmaceuticals/pharmacology, Cost-Benefit Analysis, Crohn Disease/diagnosis, Crohn Disease/economics, Crohn Disease/psychology, Crohn Disease/therapy, Drug Costs, Female, Humans, Male, Needs Assessment, Quality of Life, Quality-Adjusted Life Years, Switzerland, Time-to-Treatment/economics, Time-to-Treatment/statistics & numerical data, Crohn’s disease, arly biologic initiation, cost-effectiveness
Pubmed
Web of science
Create date
21/10/2019 14:37
Last modification date
20/08/2022 5:40
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