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

Abstract

BACKGROUND Infliximab was the first approved biologic treatment for moderate to severe Crohn’s disease (MS-CD) in China. However, the cost-effectiveness of infliximab maintenance therapy (IMT) for MS-CD relative to conventional maintenance therapy remained unclarified. AIM To assess the cost-effectiveness of IMT for MS-CD in Chinese patients from the perspective of Chinese public insurance payer. METHODS A cohort of MS-CD patients managed in a Chinese tertiary care hospital was created to compare IMT with conventional maintenance therapy (CMT) for clinical outcomes and direct medical costs over a 1-year observation time using conventional regression analyses. A decision-analytic model with the generated evidence was constructed to assess the cost-effectiveness of IMT relative to CMT using reimbursed medical costs. RESULTS Based on the included 389 patients, IMT was associated with significantly higher disease remission chance [odds ratio: 4.060, P = 0.003], lower risk of developing new complications (odds ratio: 0.527, P = 0.010), higher utility value for quality of life (coefficient 0.822, P = 0.008), and lower total hospital costs related to disease management (coefficient -0.378, P = 0.008) than CMT. Base-case cost-effectiveness analysis estimated that IMT could cost Chinese health insurance payers ¥55260 to gain one quality-adjusted life year (QALY). The cost-effectiveness of IMT was mainly driven by the estimate of quality of life, treatment efficacy of maintenance therapy, mortality risk associated with active disease, and unit price of infliximab. The probability that IMT was cost-effective at a willingness-to-pay threshold of three times gross domestic product [2018 Chinese gross domestic product per capita (GDPPC)] was 86.4%. CONCLUSION IMT significantly improved real-world health outcomes and cost the Chinese public health insurance payers less than one GDPPC to gain one QALY in Chinese MS-CD patients.

Sponsorship bias in published pharmacoeconomic evaluations of national reimbursement negotiation drugs in China: a systematic review

“…After removing duplicates, we screened 226 records and assessed 138 full-text articles based on inclusion and exclusion criteria. Eventually, 92 pharmacoeconomic evaluations were included in the review and underwent data extraction (figure 1), detailed information on included studies can be found in online supplemental table 2 19–110…”

Effectiveness and Economic Evaluation of Polyene Phosphatidyl Choline in Patients With Liver Diseases Based on Real-World Research

“…Real-world research is rooted in clinical practice and comes from a wide range of sources, including hospitalization records, laboratory examination, images, and follow-up records during diagnosis and treatment. There were multiple studies based on real-world evidence demonstrating effectiveness and economy of different drugs, such as erenumab for headache, infliximab for Crohn disease, and apatinib for metastatic colorectal cancer ( Gou et al, 2018 ; Kanaan et al, 2020 ; Shi et al, 2020 ). Our aims were to explore the effectiveness and economy of PPC in patients with liver diseases based on real-world research, compare it with other hepatoprotective drugs (alone or combination medication), and evaluate the application of PPC in specific-disease cohorts, in order to optimal regimen therapy in clinical to treat hepatopathies.…”

MALT1 reflects inflammatory cytokines, disease activity, and its chronological change could estimate treatment response to infliximab in Crohn's disease patients

“…However, the disease activity may be uncontrolled even under the administration of these above‐mentioned treatments, which require monoclonal antibodies to further control the symptoms 2,6 . Infliximab is the first biologic approved for CD treatment in China, which has comparable therapeutic efficacy to other TNF inhibitors, higher practical value, and lower costs for CD patients 7–9 . However, since only 40%–50% of CD patients would respond to infliximab treatment, their clinical outcomes remain miserable 8,10,11 .…”

“…Infliximab is the first biologic approved for CD treatment in China, which has comparable therapeutic efficacy to other TNF inhibitors, higher practical value, and lower costs for CD patients [7][8][9] . However, since only 40%-50% of CD patients would respond to infliximab treatment, their clinical outcomes remain miserable 8,10,11 .…”