Assessing the economics of biologic and small molecule therapies for the treatment of moderate to severe ulcerative colitis in Japan: a cost per responder analysis of upadacitinib.

IF 2.9 4区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Journal of Medical Economics Pub Date : 2024-01-01 Epub Date: 2024-04-05 DOI:10.1080/13696998.2024.2333683
Masayuki Saruta, Isao Kawaguchi, Yuji Ogawa, Yuri Sanchez Gonzalez, Naoki Numajiri, Xiaohe Tang, Russell Miller
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引用次数: 0

Abstract

Aim: Patients with moderately to severely active ulcerative colitis have an increasing number of advanced therapy options including several biologics and Janus kinase inhibitors. Though data on efficacy and safety of these advanced therapies are available, less is known about the potential economic implications of their utilization in Japan. We evaluated the relative value of these advanced therapies in Japan using a locally developed cost per responder model.

Methods: A model was developed using relevant clinical endpoints and treatment costs to calculate cost per responder of all advanced therapies used for moderately to severely active ulcerative colitis treatment in Japan. Cost per responder was assessed in biologic-naïve and biologic-exposed populations, respectively. The model incorporated induction and maintenance therapy pathways as patients progressed through based on efficacy rates (clinical response, clinical remission and endoscopic improvement). Total costs for induction and maintenance included: drug acquisition, drug administration and serious adverse event management (as necessary) for responders, with additional rescue treatment cost only for non-responders.

Results: Upadacitinib showed lower cost per clinical response and cost per clinical remission across both biologic-naïve and biologic-exposed populations with only one exemption in cost per clinical remission in biologic-naïve population. In addition, upadacitinib demonstrated lower cost per endoscopic improvement in both populations. Janus kinase inhibitors outperformed with lower cost per responder than other mediations across all outcomes and patient populations with the exception of tofacitinib for clinical remission in biologic-exposed UC population.

Limitations: Comparative data used in this analysis have been derived from network meta-analysis, not from direct comparison.

Conclusions: The results of this cost per responder analysis suggest upadacitinib is a cost-effective option for the first- and second-line treatment of moderately to severely active ulcerative colitis in Japan.

评估日本治疗中度至重度溃疡性结肠炎的生物疗法和小分子疗法的经济效益:奥达帕替尼的每应答者成本分析。
目的:中度至重度活动性溃疡性结肠炎患者有越来越多的先进疗法可供选择,包括多种生物制剂和 Janus 激酶抑制剂。虽然已有关于这些先进疗法的疗效和安全性的数据,但对这些疗法在日本使用的潜在经济影响却知之甚少。我们使用当地开发的每应答者成本模型评估了这些先进疗法在日本的相对价值:方法:我们利用相关临床终点和治疗成本建立了一个模型,以计算日本用于中度至重度活动性溃疡性结肠炎治疗的所有先进疗法的每应答者成本。每个应答者的成本分别在生物制剂免疫人群和生物制剂暴露人群中进行评估。该模型根据疗效率(临床反应、临床缓解和内镜改善)纳入了诱导和维持治疗路径。诱导和维持治疗的总成本包括:应答者的药物采购、给药和严重不良事件处理(必要时),无应答者仅需额外的抢救治疗成本:结果表明:无论在生物制剂无效人群还是生物制剂暴露人群中,奥达替尼的每次临床应答成本和每次临床缓解成本均较低,生物制剂无效人群的每次临床缓解成本仅有一次豁免。此外,在这两种人群中,达帕替尼每次内镜改善的成本都较低。在所有结果和患者人群中,Janus激酶抑制剂的表现均优于其他药物,每应答者的成本低于其他药物,但在生物制剂暴露的UC人群中,临床缓解的托法替尼除外:本分析中使用的比较数据来自网络荟萃分析,而非直接比较:每应答者成本分析结果表明,在日本,奥达帕替尼用于中度至重度活动性溃疡性结肠炎的一线和二线治疗具有成本效益。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Medical Economics
Journal of Medical Economics HEALTH CARE SCIENCES & SERVICES-MEDICINE, GENERAL & INTERNAL
CiteScore
4.50
自引率
4.20%
发文量
122
期刊介绍: Journal of Medical Economics'' mission is to provide ethical, unbiased and rapid publication of quality content that is validated by rigorous peer review. The aim of Journal of Medical Economics is to serve the information needs of the pharmacoeconomics and healthcare research community, to help translate research advances into patient care and be a leader in transparency/disclosure by facilitating a collaborative and honest approach to publication. Journal of Medical Economics publishes high-quality economic assessments of novel therapeutic and device interventions for an international audience
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