Cost-effectiveness of vedolizumab compared with infliximab, adalimumab, and golimumab in patients with ulcerative colitis in the United Kingdom

Wilson, Michele; Bergman, Annika; Chevrou‐Séverac, Hélène; Selby, Ross; Smyth, Michael; Kerrigan, Matthew

doi:10.1007/s10198-017-0879-5

Cited by 26 publications

(57 citation statements)

References 24 publications

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“…Our findings are consistent with two recent cost-effectiveness analyses in the UK and Spain that examined VDZ compared with ADA, GOL, and IFX for the treatment of patients with moderate-to-severe UC who were anti-TNF-naïve [18,19]. Both studies also showed that long-term treatment with VDZ was associated with greater QALYs compared with ADA, GOL, and IFX [18,19]. In the UK analysis, the time horizon was 30 years as a proxy for lifetime, and VDZ was dominant over GOL and IFX and cost-effective compared with ADA [18].…”

Section: Discussionsupporting

confidence: 91%

“…Both studies also showed that long-term treatment with VDZ was associated with greater QALYs compared with ADA, GOL, and IFX [18,19]. In the UK analysis, the time horizon was 30 years as a proxy for lifetime, and VDZ was dominant over GOL and IFX and cost-effective compared with ADA [18]. The analysis from Spain used a time horizon of 10 years [19].…”

Section: Discussionmentioning

confidence: 99%

“…The efficacy and safety of VDZ for the treatment of patients with moderate-to-severe active UC have been demonstrated in an international study, GEMINI I, and a Japanese phase III VDZ study [15,16]. Previous studies have assessed the longterm clinical and economic consequences and cost-effectiveness of VDZ compared with other biologics for the treatment of patients with moderate-to-severe UC in the context of the United Kingdom (UK), Spain, and the United States (US) [17][18][19][20]. However, this information is still unknown in Japan and can be useful for decision makers at the time of repricing biologics for the treatment of patients with moderate-tosevere UC who have not sufficiently responded to CT.…”

Section: Key Points For Decision Makersmentioning

confidence: 99%

“…Health state utilities were not available from patients with UC in Japan at the time of this analysis and were obtained from previous studies in patients from the UK (Table 2) [49,50]. Utility decrements associated with AEs were obtained from a previous cost-effectiveness analysis of VDZ for the treatment of patients with moderate-to-severe UC in the UK (Table 1), assuming the duration of all AEs was 8 weeks during induction and maintenance [18,51].…”

Section: Utilitiesmentioning

confidence: 99%

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Cost-Effectiveness Analysis of Vedolizumab Compared with Other Biologics in Anti-TNF-Naïve Patients with Moderate-to-Severe Ulcerative Colitis in Japan

et al. 2019

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Background Vedolizumab (VDZ) was approved by the Japanese Ministry of Health, Labor and Welfare in 2018 for the treatment of patients with moderate-to-severe active ulcerative colitis (UC). The comparative cost-effectiveness of VDZ compared with other biologics is unknown in Japan. This information could be useful for decision makers at the time of repricing biologics for the treatment of patients with moderate-to-severe UC. Objective The aim was to assess the cost-effectiveness of VDZ versus other branded biologics for the treatment of patients with moderate-to-severe UC who were anti-tumor necrosis factor (TNF)-naïve, from the Japanese public healthcare payer perspective. Methods A hybrid decision tree/Markov model was developed to predict the number of patients who achieved response and remission at the end of the induction phase and sustained it during the maintenance phase, translating this into qualityadjusted life-years (QALYs) and costs. Treatment-related adverse events, discontinuation and surgery, and their impact on QALYs and costs were also modeled. A systematic literature review and network meta-analysis were conducted to estimate the comparative efficacy of each treatment versus placebo. Rates of adverse events, surgery, surgery complications, and utilities were from the literature. Costs (2018 Japanese yen) were obtained from the Japanese National Health Insurance drug price list and medical fee table and local claims databases. Clinical and economic outcomes were projected over a lifetime and discounted at 2% annually. Results Over a lifetime, VDZ yielded greater QALYs and cost savings compared with golimumab and was cost-effective compared with adalimumab and infliximab (incremental cost-effectiveness ratios ¥4,821,940 and ¥4,687,692, respectively). Deterministic and probabilistic analyses supported the robustness of the findings in the base-case analysis, indicating that VDZ was either dominant or cost-effective in most scenarios and replications. The main limitations of this analysis include excluding tofacitinib and infliximab biosimilar as comparators, health-state utility estimates were obtained from population studies in the United Kingdom, and the impact of subsequent (i.e., second-line) biologic treatment was not evaluated. Conclusion Our analysis suggests that VDZ is dominant or cost-effective compared with other branded biologics for the treatment of anti-TNF-naïve patients with moderate-to-severe UC in Japan.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Key Points For Decision Makersmentioning

confidence: 99%

Section: Utilitiesmentioning

confidence: 99%

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Cost-Effectiveness Analysis of Vedolizumab Compared with Other Biologics in Anti-TNF-Naïve Patients with Moderate-to-Severe Ulcerative Colitis in Japan

et al. 2019

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“…Wilson et al examined the clinical and economic impact of VDZ compared with IFX, ADA, and golimumab in the treatment of moderately to severely active UC in the United Kingdom. 71 Compared with the other biologics, VDZ was the more effective treatment. When considering costs and a lifetime time horizon, VDZ was dominant (more effective and less costly) compared with all other biologics.…”

Section: Place In Therapymentioning

confidence: 99%

<p>Vedolizumab in the Treatment of Ulcerative Colitis: An Evidence-Based Review of Safety, Efficacy, and Place of Therapy</p>

Takatsu¹,

Hisabe²,

Higashi³

et al. 2020

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Introduction: Selective blockade of the integrins and mucosal adhesion molecules is a promising therapeutic strategy for ulcerative colitis (UC). Vedolizumab (VDZ), a humanized IgG1 monoclonal antibody against α4β7 integrin, selectively blocks the trafficking of the leukocytes into the gastrointestinal tract through its binding with the α4β7 integrin. Aim: In this review, we provide an overview of the unique mechanism of VDZ, along with its efficacy, safety, and pharmacokinetic and pharmacodynamic data obtained from clinical trials, observational studies, and meta-analyses. Evidence Review: A positive exposure-efficacy relationship with regard to clinical remission and clinical response was apparent in VDZ induction therapy. No drug-specific safety signals are currently available. Place in Therapy: VDZ has been shown to be effective as firstor second-line induction and maintenance therapy in UC. Conclusion: VDZ is a safe and effective treatment option for patients with UC. Prolonged VDZ induction therapy may contribute to improved outcomes in patients with UC, particularly those previously treated with tumor necrosis factor-α. Prospective head-to-head study of VDZ and other biologics would alter the positioning of VDZ much more clearly.

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Albumin nano-encapsulation of caffeic acid phenethyl ester and piceatannol potentiated its ability to modulate HIF and NF-kB pathways and improves therapeutic outcome in experimental colitis

Tambuwala

Khan

Thompson

et al. 2018

Drug Deliv. and Transl. Res.

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Hypoxia inducible factor and nuclear factor-kappa beta pathways have been proposed as therapeutic targets for several inflammatory diseases. Caffeic acid phenethyl ester (CAPE) and piceatannol (PIC) are natural anti-inflammatory compounds; however, poor bioavailability and limited understanding of biomolecular mechanistic limits its clinical use. The aims of this study are to enhance bioavailability and investigate their impact on nuclear p65 and HIF-1α for the first time in experimental colitis.Dextran sulphate sodium was used to induce colitis in mice and effect of either free CAPE/PIC or CAPE/PIC loaded albumin nanoparticles treatment was observed on disease development and levels of cellular p65 and HIF-1α.Our results indicate that albumin nano-encapsulation of CAPE/PIC not only enhances its anti-inflammatory potential but also potentiates its ability to effectively modulate inflammation related biomolecular pathways. Hence, combining nanotechnology with natural compounds could result in development of new therapeutic options for IBD.Electronic supplementary materialThe online version of this article (10.1007/s13346-018-00597-9) contains supplementary material, which is available to authorized users.

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Cost-effectiveness of vedolizumab compared with infliximab, adalimumab, and golimumab in patients with ulcerative colitis in the United Kingdom

Abstract: Our model predicted that treatment with vedolizumab improves QALY, increases time in remission and response, and is a cost-effective treatment option compared with all other biologics for biologic-naïve patients with moderately to severely active UC.

Cited by 26 publications

References 24 publications

Cost-Effectiveness Analysis of Vedolizumab Compared with Other Biologics in Anti-TNF-Naïve Patients with Moderate-to-Severe Ulcerative Colitis in Japan

Cost-Effectiveness Analysis of Vedolizumab Compared with Other Biologics in Anti-TNF-Naïve Patients with Moderate-to-Severe Ulcerative Colitis in Japan

<p>Vedolizumab in the Treatment of Ulcerative Colitis: An Evidence-Based Review of Safety, Efficacy, and Place of Therapy</p>

Albumin nano-encapsulation of caffeic acid phenethyl ester and piceatannol potentiated its ability to modulate HIF and NF-kB pathways and improves therapeutic outcome in experimental colitis

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