Modelling the Cost-Effectiveness of First Line Biologics for Rheumatoid Arthritis in Ireland

Introduction. Rheumatoid arthritis (RA) is a chronic progressive inflammatory disease that causes joint destruction. The condition imposes a significant economic burden on patients and societies. The present study is aimed at evaluating the cost-effectiveness of Infliximab, Adalimumab, and Etanercept in treating rheumatoid arthritis in Iran. Methods. This is a cost-effectiveness study of economic evaluation in which the Markov model was used. The study was carried out on 154 patients with rheumatoid arthritis in Fars province taking Infliximab, Adalimumab, and Etanercept. The patients were selected through sampling. In this study, the cost data were collected from a community perspective, and the outcomes were the mean reductions in DAS-28 and QALY. The cost data collection form and the EQ-5D questionnaire were also used to collect the required data. The results were presented in the form of an incremental cost-effectiveness ratio, and the sensitivity analysis was used to measure the robustness of the study results. The TreeAge Pro and Excel softwares were used to analyze the collected data. Results. The results showed that the mean costs and the QALY rates in the Infliximab, Adalimumab, and Etanercept arms were $ 79,518.33 and 12.34, $ 91,695.59 and 13.25, and $ 87,440.92 and 11.79, respectively. The one-way sensitivity analysis confirmed the robustness of the results. In addition, the results of the probabilistic sensitivity analysis (PSA) indicated that on the cost-effectiveness acceptability curve, Infliximab was in the acceptance area and below the threshold in 77% of simulations. The scatter plot was in the mentioned area in 81% and 91% of simulations compared with Adalimumab and Etanercept, respectively, implying lower costs and higher effectiveness than the other two alternatives. Therefore, the strategy was more cost-effective. Conclusion. According to the results of this study, Infliximab was more cost-effective than the other two medications. Therefore, it is recommended that physicians use this medication as the priority in treating rheumatoid arthritis. It is also suggested that health policymakers consider the present study results in preparing treatment guidelines for RA.

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The cost-effectiveness of TNF-inhibitors for the treatment of rheumatoid arthritis in Swedish clinical practice

The European Journal of Health Economics ◽

10.1007/s10198-012-0431-6 ◽

2012 ◽

Vol 14 (6) ◽

pp. 863-873 ◽

Cited By ~ 17

Author(s):

Ingrid Lekander ◽

Fredrik Borgström ◽

Jörgen Lysholm ◽

Ronald F. van Vollenhoven ◽

Staffan Lindblad ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Clinical Practice ◽

Cost Effectiveness ◽

Tnf Inhibitors ◽

The Cost

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First-Line Pembrolizumab Plus Chemotherapy for Extensive-Stage Small-Cell Lung Cancer: A Cost-Effectiveness Analysis

10.21203/rs.3.rs-725799/v1 ◽

2021 ◽

Author(s):

Youwen Zhu ◽

Huabin Hu ◽

Dong Ding ◽

Shuosha Li ◽

Mengting Liao ◽

...

Keyword(s):

Cost Effectiveness ◽

Cost Effective ◽

Small Cell ◽

Sensitivity Analyses ◽

Small Cell Lung ◽

First Line ◽

The Us ◽

Extensive Stage ◽

The Cost ◽

First Line Treatment

Abstract Background：The phase III clinical trial Keynote-604 indicated that pembrolizumab plus chemotherapy could generate clinical benefits in Extensive-Stage Small-Cell Lung Cancer (ES-SCLC). We aim to evaluate the cost-effectiveness of pembrolizumab plus chemotherapy as the first-line treatment of ES-SCLC from the United States (US) payers’ perspective.Methods: A synthetical Markov model was used to evaluate cost and effectiveness of pembrolizumab plus platinum-etoposide (EP) versus EP in first-line therapy for ES-SCLC from the data of Keynote-604. Lifetime costs life-years (LYs), quality adjusted LYs (QALYs), and incremental cost-effectiveness ratios (ICERs) were estimated. One-way and probabilistic sensitivity analyses were performed. In addition, We also considered subgroup cost-effectiveness.Results: Pembrolizumab plus EP resulted in additional 0.18 QALYs (0.32 LYs) and corresponding incremental costs $113,625, resulting an ICER of $647,509 per QALY versus EP. The most influential factor in this model was the cost of pembrolizumab. Probabilistic sensitivity analysis showed there was 0% probability that pembrolizumab combination chemotherapy was cost-effective at willingness-to-pay (WTP) values of $150,000 per QALY in the US. The results of subgroup probabilistic sensitivity analyses suggested that all subgroups were not cost-effective.Conclusion: From the perspective of the US payer, pembrolizumab plus EP is not a cost-effective option as first-line treatment for patients with ES-SCLC at a WTP threshold of $150,000 per QALY.

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Dacomitinib in first-line treatment of advanced EGFR-mutated non-small-cell lung cancer: a cost–effectiveness analysis

Journal of Comparative Effectiveness Research ◽

10.2217/cer-2020-0233 ◽

2021 ◽

Author(s):

Javier Aguilar-Serra ◽

Vicente Gimeno-Ballester ◽

Alfonso Pastor-Clerigues ◽

Javier Milara ◽

Ezequiel Marti-Bonmati ◽

...

Keyword(s):

Cost Effectiveness ◽

Incremental Cost ◽

Quality Adjusted Life Year ◽

Incremental Cost Effectiveness Ratio ◽

Line Treatment ◽

Cost Effectiveness Ratio ◽

First Line ◽

Estimate Quality ◽

The Cost ◽

First Line Treatment

Aim: To assess the cost–effectiveness of first-line treatment with dacomitinib compared with gefitinib in patients newly diagnosed with advanced NSCLC EGFR-positive in the context of Spain. Materials & methods: A partitioned survival model was developed including costs, utilities and disutilities to estimate quality-adjusted life-year (QALY) and incremental cost–effectiveness ratio when treating with dacomitinib versus gefitinib. Results: Dacomitinib presented higher QALYs (0.51) compared with gefitinib (0.45). Dacomitinib costs were €33,061 in comparison with €26,692 for gefitinib arm. An incremental cost–effectiveness ratio of €111,048 was obtained for dacomitinib. Conclusion: Dacomitinib was more effective in terms of QALYs gained than gefitinib. However, to obtain a cost–effectiveness alternative, a discount greater than 25% in dacomitinib acquisition cost is required.

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The Effect of Dose Escalation on the Cost-Effectiveness of Etanercept and Adalimumab with Methotrexate Among Patients with Moderate to Severe Rheumatoid Arthritis

Journal of Managed Care & Specialty Pharmacy ◽

10.18553/jmcp.2020.26.10.1236 ◽

2020 ◽

Vol 26 (10) ◽

pp. 1236-1242

Author(s):

Devin Incerti ◽

Ervant J. Maksabedian Hernandez ◽

Joseph Tkacz ◽

Jeroen P. Jansen ◽

David Collier ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Cost Effectiveness ◽

Dose Escalation ◽

Severe Rheumatoid Arthritis ◽

The Cost

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The Cost-Effectiveness of Catheter Ablation as First-Line Treatment

Value in Health ◽

10.1016/j.jval.2013.08.1298 ◽

2013 ◽

Vol 16 (7) ◽

pp. A529

Author(s):

M. Aronsson ◽

H. Walfridsson ◽

M. Janzon ◽

U. Walfridsson ◽

L.Å Levin

Keyword(s):

Cost Effectiveness ◽

Catheter Ablation ◽

Line Treatment ◽

First Line ◽

The Cost ◽

First Line Treatment

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Consequences of Biomarker Analysis on the Cost-Effectiveness of Cetuximab in Combination with FOLFIRI as a First-Line Treatment of Metastatic Colorectal Cancer: Personalised Medicine at Work

Applied Health Economics and Health Policy ◽

10.1007/s40258-018-0395-5 ◽

2018 ◽

Vol 16 (4) ◽

pp. 515-525 ◽

Cited By ~ 4

Author(s):

Gerard Harty ◽

James Jarrett ◽

Mireia Jofre-Bonet

Keyword(s):

Colorectal Cancer ◽

Cost Effectiveness ◽

Metastatic Colorectal Cancer ◽

Personalised Medicine ◽

Line Treatment ◽

First Line ◽

Biomarker Analysis ◽

The Cost ◽

First Line Treatment

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The cost-effectiveness of pegaspargase versus native asparaginase for first-line treatment of acute lymphoblastic leukaemia: a UK-based cost-utility analysis

Health Economics Review ◽

10.1186/s13561-019-0257-3 ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 2

Author(s):

Xingdi Hu ◽

Kingsley P. Wildman ◽

Subham Basu ◽

Peggy L. Lin ◽

Clare Rowntree ◽

...

Keyword(s):

Cost Effectiveness ◽

Cost Effective ◽

Line Treatment ◽

Newly Diagnosed ◽

First Line ◽

Link Type ◽

Search Trial ◽

Erwinia Asparaginase ◽

The Uk ◽

The Cost

Abstract Background L-asparaginase is a key component of treatment for patients with acute lymphoblastic leukaemia (ALL) in the UK. Commonly used forms of asparaginase are native E. coli-derived asparaginase (native asparaginase) and pegaspargase in first-line combination therapy, and native Erwinia chrysanthemi-derived asparaginase (Erwinia asparaginase) as second-line treatment. The objective of this study was to evaluate the cost-effectiveness of pegaspargase versus native asparaginase in first-line combination therapy for patients with newly diagnosed ALL. A combined decision tree and health-state transition Markov cost-effectiveness model was developed to assess the relative costs and health outcomes of pegaspargase versus native asparaginase in the UK setting. Results In base case analyses, first-line pegaspargase (followed by Erwinia asparaginase in cases of hypersensitivity) dominated first-line native asparaginase followed by Erwinia asparaginase; i.e. resulted in lower costs and more quality-adjusted life year gain. The favourable hypersensitivity rates and administration profile of pegaspargase led to lifetime cost savings of £4741 versus native asparaginase. Pegaspargase remained cost-effective versus all treatment strategies in all scenario analyses, including use of the 2500 IU/m2 dose, recommended for patients ≤21 years of age. Conclusions Pegaspargase, as part of multi-drug chemotherapy, is a cost-effective option for the treatment of newly diagnosed ALL. Based on this study, The National Institute for Health and Care Excellence Technology Appraisal Committee concluded that it could recommend pegaspargase as a cost-effective use of National Health Service resources in England & Wales for treating ALL in children, young people and adults with untreated, newly diagnosed disease. Trial registration UKALL 2011, EudraCT number 2010-020924-22; UKALL 2003, EudraCT number 2007-004013-34; UKALL14, EudraCT number 2009-012717-22.

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