Cost-effectiveness of tofacitinib compared with infliximab, adalimumab, golimumab, vedolizumab and ustekinumab for the treatment of moderate to severe ulcerative colitis in Germany

Sardesai, Aditya; Dignaß, Axel; Quon, Peter; Milev, Sandra; Cappelleri, Joseph C.; Kisser, Agnes; Modesto, Irene; Sharma, Puneet

doi:10.1080/13696998.2021.1881323

Cited by 11 publications

(12 citation statements)

References 36 publications

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“…Previous analyses analyzed the cost effectiveness of tofacitinib in moderate-to-severe active UC patients in different settings. In Great Britain, tofacitinib was likely to be cost effective [ 18 ]; similar scenarios were found in Germany [ 16 ], Greece [ 54 ] and Canada, and tofacitinib was found to be the optimal therapy in second-line patients [ 40 ] and in middle-income China [ 55 ]. No other cost-effectiveness analyses exist for Colombia, hence it was not possible to compare the results of this study with other publications.…”

Section: Discussionmentioning

confidence: 93%

“…The health states included remission, treatment response (without remission), active UC, colectomy, and post-colectomy. The model design was based on that presented in previous studies [ 16 – 18 ], one of which was a systematic review of the economic models. The model was validated by clinical experts familiar with clinical practices in Colombia.…”

Section: Methodsmentioning

confidence: 99%

“…The utility weights were stratified by phase [ 40 ]. Colectomy was extracted from previously published models [ 16 , 41 ]. The utility values used in the model are presented in Table 2 .…”

Section: Methodsmentioning

confidence: 99%

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Cost Effectiveness of Tofacitinib for the Treatment of Moderate to Severe Active Ulcerative Colitis in Colombia

Parada

Baños

Amador³

et al. 2022

PharmacoEconomics Open

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Objective The aim of this study was to evaluate the cost effectiveness of tofacitinib versus other treatment options currently available in Colombia in naïve to biologics (first-line) and exposed to biologics (second-line) patients with moderate to severe active ulcerative colitis (UC). Methods A Markov model was constructed with 8-week cycles, simulating a cohort of patients in a 5-year time horizon. The health states included remission, treatment response, active UC, and colectomy. The transition probabilities for the induction and maintenance phase were obtained from a network meta-analysis, and effectiveness was measured using quality-adjusted life-years (QALYs). Unit costs were derived from official national sources. Results For first line, the incremental cost-effectiveness ratio (ICER) per QALY was $883 for tofacitinib and $3619 for infliximab, compared with adalimumab. Sensitivity analysis showed that tofacitinib is cost effective in 45% of the iterations, adalimumab in 5%, and infliximab in 50%. Meanwhile, the ICER of adalimumab was $14,927 compared with tofacitinib in second-line treatment. In the sensitivity analysis, tofacitinib was cost effective in 64% of the iterations, followed by adalimumab in 36%. Infliximab and golimumab were not included due to data limitations in the network meta-analysis of second-line treatment. Conclusion The analysis suggests that in Colombia, treatment with tofacitinib for patients with moderate-to-severe UC is a cost-effective option in both lines compared with other treatment options. Supplementary Information The online version contains supplementary material available at 10.1007/s41669-022-00360-4.

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Section: Discussionmentioning

confidence: 93%

Section: Methodsmentioning

confidence: 99%

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Cost Effectiveness of Tofacitinib for the Treatment of Moderate to Severe Active Ulcerative Colitis in Colombia

Parada

Baños

Amador³

et al. 2022

PharmacoEconomics Open

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“…Over the last 50 years there has been an increase in the medications that have become available for the treatment of IBD. However, as the understanding of IBD increases and new treatment targets are identified, the medications being developed are expensive due to high production costs [1][2][3][4]. With health care costs rising globally, many health systems may benefit from optimising older, simpler and cheaper therapies [5][6][7].…”

Section: Why It's Important To Review This Topicmentioning

confidence: 99%

Low-Dose Azathioprine in Combination with Allopurinol: The Past, Present and Future of This Useful Duo

Turbayne

Sparrow

2022

Dig Dis Sci

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The inflammatory bowel diseases (IBD) are complex immune-mediated inflammatory diseases that are associated with significant morbidity around the world. As our understanding of IBD, and other immune-mediated inflammatory diseases, advances the number of therapeutic targets has increased which has rapidly driven the development and introduction of new therapies. While these new therapies have shown promise they come with the significant drawback of high costs. For many IBD patients around the world the cost of newer therapies is prohibitive which means treating clinicians often need to turn to optimising simpler, older, and inexpensive medications. The concept of optimising well established cheaper medications is not unique to the management of IBD as health systems all over the world look to reduce costs while simultaneously improving patient outcomes. Despite thiopurines being used in the management IBD for over 60 years, many clinicians are still hesitant to use them due to perceptions around limited efficacy and poor tolerance. One method identified to potentially increase utilisation of thiopurines involves the coadministration of allopurinol. In this review we will explore the history, pharmacology, recent studies and give recommendations for the utilisation of the usual duo of azathioprine combined with allopurinol.

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“…Therapy may be optimized through personalized approaches based on disease severity, lesion location, and phenotypes in addition to the use of therapeutic and clinical targets [57][58][59]. Future research should quantify the relative contribution of each of these choices to overall treatment success, as a recent economic study suggests that tofacitinib may be more cost-effective than any injectable biologic [60]. Table 2 summarizes the non-biological small molecules under current investigation for CD and UC.…”

Section: Combining Biosimilars With Non-biologic Small Moleculesmentioning

confidence: 99%

Biosimilar Interchangeability and Emerging Treatment Strategies for Inflammatory Bowel Diseases: A Commentary

Parrish

2021

Gastroenterology Insights

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This commentary summarizes a collection of key references published within the last ten years, and identifies pharmacologic research directions to improve treatment access and success through greater biosimilar or “follow-on” biologic utilization combined with other targeted small molecule agents that possess unique pathophysiologic mechanisms for inflammatory bowel diseases (IBD) in adult and pediatric patients. Since they are not identical to the originator or reference biologic agent, all biosimilars are not generically equivalent. However, in the US and other countries, they are considered therapeutically interchangeable if the manufacturer has demonstrated no clinically meaningful differences from the reference product. Comparisons of different clinical initiation and switching scenarios are discussed with reference to interchangeability, immunogenicity, nocebo effect, cost effectiveness, and time courses for discontinuation rates.

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Cost-effectiveness of tofacitinib compared with infliximab, adalimumab, golimumab, vedolizumab and ustekinumab for the treatment of moderate to severe ulcerative colitis in Germany

Cited by 11 publications

References 36 publications

Cost Effectiveness of Tofacitinib for the Treatment of Moderate to Severe Active Ulcerative Colitis in Colombia

Cost Effectiveness of Tofacitinib for the Treatment of Moderate to Severe Active Ulcerative Colitis in Colombia

Low-Dose Azathioprine in Combination with Allopurinol: The Past, Present and Future of This Useful Duo

Biosimilar Interchangeability and Emerging Treatment Strategies for Inflammatory Bowel Diseases: A Commentary

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