Cost-Effectiveness of Rituximab (Fixed-Schedule vs Tailored-Dose) Compared With Azathioprine Maintenance Therapy in Adults With Generalized Antineutrophil Cytoplasm Antibody-Associated Vasculitis in Colombia

2022 ◽  
Vol 28 ◽  
pp. 98-104
Author(s):  
Kateir Contreras ◽  
Viviana Orozco ◽  
Eduardo Puche ◽  
Camilo A. González ◽  
Paola García-Padilla ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Maintenance Therapy

scholarly journals Real-world cost-effectiveness associated with infliximab maintenance therapy for moderate to severe Crohn’s disease in China

2020 ◽  
Vol 26 (41) ◽  
pp. 6455-6474
Author(s):  
Ji-Hao Shi ◽  
Liang Luo ◽  
Xiao-Li Chen ◽  
Yi-Peng Pan ◽  
Zhou Zhang ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Cost Effectiveness ◽  
Crohn's Disease ◽  
Maintenance Therapy ◽  
Real World

scholarly journals Cost-effectiveness analysis of ixekizumab versus secukinumab in patients with psoriatic arthritis and concomitant moderate-to-severe psoriasis in Spain

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e032552 ◽  
Author(s):  
Bernd Schweikert ◽  
Chiara Malmberg ◽  
Mercedes Núñez ◽  
Tatiana Dilla ◽  
Christophe Sapin ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Cost Effectiveness ◽  
Maintenance Therapy ◽  
Induction Period ◽  
Severity Index ◽  
Cost Effectiveness Analysis ◽  
Severe Psoriasis ◽  
Base Case ◽  
Psoriasis Area Severity Index ◽  
Effectiveness Analysis

ObjectiveTo conduct a cost-effectiveness analysis from the perspective of the Spanish National Health System (NHS) comparing ixekizumab versus secukinumab.DesignA Markov model with a lifetime horizon and monthly cycles was developed based on the York model. Four health states were included: a biological disease-modifying antirheumatic drug (bDMARD) induction period of 12 or 16 weeks, maintenance therapy, best supportive care (BSC) and death. Treatment response was assessed based on both Psoriatic Arthritis Response Criteria (PsARC) and ≥90% improvement in the Psoriasis Area Severity Index score (PASI90). At the end of the induction period, responders transitioned to maintenance therapy. Non-responders and patients who discontinued maintenance therapy transitioned to BSC. Clinical efficacy data were derived from a network meta-analysis. Health utilities were generated by applying a regression analysis to Psoriasis Area Severity Index and Health Assessment Questionnaire‒Disability Index scores collected in the ixekizumab SPIRIT studies. Results were subject to extensive sensitivity and scenario analysis.SettingSpanish NHS.ParticipantsA hypothetical cohort of bDMARD-naïve patients with psoriatic arthritis and concomitant moderate-to-severe psoriasis was modelled.InterventionsIxekizumab and secukinumab.ResultsIxekizumab performed favourably over secukinumab in the base-case analysis, although cost savings and quality-adjusted life-year (QALY) gains were modest. Total costs were €153 901 compared with €156 559 for secukinumab (difference −€2658). Total QALYs were 9.175 vs 9.082 (difference 0.093). Base-case results were most sensitive to the annual bDMARD discontinuation rate and the modification of PsARC and PASI90 response to ixekizumab or secukinumab.ConclusionIxekizumab provided more QALYs at a lower cost than secukinumab, with differences being on a relatively small scale. Sensitivity analysis showed that base-case results were generally robust to changes in most input parameters.Trial registration numberSPIRIT-P1: NCT01695239; Post-results, SPIRIT-P2: NCT02349295; Post-results.

The cost-effectiveness of buprenorphine maintenance therapy for opiate addiction in the United States

Addiction ◽  
2001 ◽  
Vol 96 (9) ◽  
pp. 1267-1278 ◽  
Author(s):  
Paul G. Barnett ◽  
Gregory S. Zaric ◽  
Margaret L. Brandeau
Keyword(s):  
United States ◽  
Cost Effectiveness ◽  
Maintenance Therapy ◽  
The United States ◽  
Opiate Addiction ◽  
The Cost

796 Cost-Effectiveness of Surveillance for Ulcerative Colitis-Associated Colorectal Cancer in the Setting of 5-ASA Maintenance Therapy

2008 ◽  
Vol 134 (4) ◽  
pp. A-112
Author(s):  
Joel H. Rubenstein ◽  
Akbar K. Waljee ◽  
Fernando S. Velayos ◽  
Uri Ladabaum ◽  
Peter D. Higgins
Keyword(s):  
Colorectal Cancer ◽  
Ulcerative Colitis ◽  
Cost Effectiveness ◽  
Maintenance Therapy

PARP inhibitor maintenance therapy for patients with platinum-sensitive recurrent ovarian cancer: A cost-effectiveness analysis

2015 ◽  
Vol 139 (1) ◽  
pp. 59-62 ◽  
Author(s):  
Haller J. Smith ◽  
Christen L. Walters Haygood ◽  
Rebecca C. Arend ◽  
Charles A. Leath ◽  
J. Michael Straughn
Keyword(s):  
Ovarian Cancer ◽  
Cost Effectiveness ◽  
Maintenance Therapy ◽  
Parp Inhibitor ◽  
Recurrent Ovarian Cancer ◽  
Cost Effectiveness Analysis ◽  
Platinum Sensitive ◽  
Effectiveness Analysis

Cost Effectiveness Analysis of Rituximab Maintenance In Patients with Untreated High Tumour Burden Follicular Lymphoma After Response to Immunochemotherapy: A UK National Healthcare Services Perspective.

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 3833-3833
Author(s):  
Konstantinos Papadakis ◽  
George A Follows ◽  
John Boyer ◽  
Zahid Bashir ◽  
Philip Ball ◽  
...  
Keyword(s):  
Overall Survival ◽  
Cost Effectiveness ◽  
Cost Saving ◽  
Maintenance Therapy ◽  
Willingness To Pay ◽  
Follicular Lymphoma ◽  
Health State ◽  
National Healthcare ◽  
Chemotherapy Induction ◽  
The Cost

Abstract Abstract 3833 Introduction: The PRIMA Phase III study demonstrates that rituximab (R) maintenance therapy after induction immunochemotherapy in previously untreated follicular lymphoma (FL) significantly improves progression-free survival (PFS) with little additional toxicity (Salles et al., 2009). Utilising clinical evidence from PRIMA, this economic analysis evaluated whether R-maintenance therapy in FL patients after response to R-chemotherapy induction is a cost-effective option compared to observational (Obs) practices in the UK National Healthcare System. METHODS: A transition state (Markov) model was developed with FL patients having a complete/partial response to 1st line R-chemotherapy induction being assigned across 4 health states reflecting their disease status; progression-free in 1st line maintenance (PF1), progression-free in 2nd line, progressive disease (PD) or Death. The model was developed over a 25 year horizon to capture the lifetime of an average patient. This required extrapolation of PFS beyond the PRIMA trial follow-up period (median 38.37 months; PFS hazard ratio 0.55; 95% CI [0.44-0.68]; Clinical Study report addendum) using the best parametric fit (Gompertz). The monthly probability of dying in PF1 was based on the maximum of either the observed PFS deaths in PRIMA or background mortality. The disposition of 1st line R-maintenance patients after progression was based on ESMO guidelines (Dreyling et al., 2010) and PRIMA. Due to extensive censoring of overall survival in PRIMA (95% and 97% in the respective R and Obs arms), the probabilities of progressing or dying in second-line or third line were obtained from the EORTC 20981 trial (van Oers et al., 2010). Predicted time in each health state was weighted using FL utility scores (Pettengell et al. 2008) to account for quality of life and estimate the Quality Adjusted Life Years (QALYs). Costs associated with the average dose of R-maintenance, post-progression treatments and managing grade 3/4 adverse events observed in PRIMA were incorporated into the relevant health state. Drug administration, patient monitoring and pharmacy costs were informed by expert opinion and the NHS schedule of reference costs. RESULTS: The average overall survival in the 1st line R-maintenance cohort was projected to be 1.27 years longer on average than in the Obs cohort (10.31 vs 9.05); and associated with an additional 1.17 QALYs. This is largely due to patients treated with 1st line R-maintenance spending more time in progression-free in first line (1.17 years). Total costs were £14,129 higher in the 1st line R-maintenance than the Obs arm and were driven by the cost of the study drug and its administration. However, this was partially compensated by the lower costs of rituximab therapy in 2nd line (cost saving £198) and the lower costs of supportive care incurred at disease progression (cost saving £906). The incremental cost-effectiveness ratios (ICERs) for 1st line R maintenance was £14,712 Life Year Gained and £15,983 per QALY gained, well below an assumed willingness to pay threshold of £30,000. Although there is uncertainty associated with the progression of FL and relapse treatment costs, the ICER did not exceed £21,155 per QALY despite a wide variation in each parameter value used in both the probabilistic and deterministic sensitivity analysis. CONCLUSIONS: The cost-effectiveness of R-maintenance in FL patients after response to R-chemotherapy is well within the acceptable willingness to pay ceiling and remains valid under most plausible sensitivity scenarios. This provides adequate reassurance that the superior clinical benefits of 1st line R-maintenance are sufficient to justify the additional costs over observational practice. Disclosures: Papadakis: F. Hoffmann-La Roche Ltd: Employment. Boyer:F. Hoffmann-La Roche Ltd: Employment. Bashir:F. Hoffmann-La Roche Ltd: Employment. Ball:F. Hoffmann-La Roche Ltd: Employment. Aultman:F. Hoffmann-La Roche Ltd: Employment. Carr:F. Hoffmann-La Roche Ltd: Employment.

SOLO1 versus SOLO2: Cost-effectiveness of olaparib as maintenance therapy for newly diagnosed and platinum-sensitive recurrent ovarian carcinoma among women with germline BRCA mutations (gBRCAmut).

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 5545-5545 ◽  
Author(s):  
Juliet Elizabeth Wolford ◽  
Krishnansu Sujata Tewari ◽  
Su-Ying Liang ◽  
Jiaru Bai ◽  
Amandeep Kaur Mann ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Maintenance Therapy ◽  
Ovarian Carcinoma ◽  
Cost Effective ◽  
Parp Inhibitors ◽  
Phase 3 ◽  
Brca Mutations ◽  
Advanced Ovarian Carcinoma ◽  
Platinum Sensitive ◽  
Maintenance Study

5545 Background: With the December 19, 2018 regulatory approval by the US FDA of olaparib tablets as maintenance therapy for women with deleterious or suspected deleterious germline or somatic BRCAmut advanced ovarian carcinoma, it becomes important to clarify the role of PARP inhibitors in this disease. We evaluated cost-effectiveness of olaparib in the upfront (SOLO1) versus the recurrent maintenance setting (SOLO2). Methods: Data were obtained from SOLO1, the phase 3 placebo-controlled randomized upfront maintenance study among gBRCAmut patients [median PFS greater than 49.8 vs 13.8m: HR 0.30; 95% CI, 0.23-0.41; p < 0.001, NCT01844986] and SOLO2, the phase 3 placebo-controlled randomized maintenance study among gBRCAmut patients with platinum-sensitive recurrence and at least two prior lines of therapy [median PFS 19.1 vs 5.5m: HR 0.30; 95% CI, 0.22-0.41; p < 0.0001, NCT01874353]. Investigator-assessed median PFS and toxicity data from the trials were incorporated in a Markov model which transitioned patients through response, hematologic complications, non-hematologic complications, progression, and death. Using TreeAge Pro 2015, the costs of pre-treatment testing (eg. gBRCAmut), medications, and management of adverse effects were analyzed. Incremental cost-effectiveness ratios (ICERs) per month of life gained and individual PFS-life year saved (PFS-LYS) were also calculated and compared. Results: In SOLO1, cost prior to progression was 1.7x that of SOLO2 ($937,440 vs $564,451). With the extended, estimated median PFS of at least 49.8m for SOLO1 and 19.1m for SOLO2, upfront maintenance therapy was more cost-effective. SOLO 1 was associated with $312,480 PF-LYS per individual patient, while SOLO2 demonstrated $498,045 PF-LYS. Maintenance olaparib was found to be more cost-effective in the 1st-line setting, with an ICER of $12,149 per month of life gained when compared directly to SOLO2. Conclusions: Although the higher cost associated with olaparib in SOLO1 reflects the longer time patients stay on drug due to extended PFS, the ICER supports early use in the disease course as first-line maintenance therapy among women with gBRCAmut advanced ovarian carcinoma.

Sign in / Sign up

Export Citation Format

Share Document