Modelling Adverse Events in Patients Receiving Chronic Oral Corticosteroids in the UK.

IF 2 Q2 ECONOMICS

PharmacoEconomics Open Pub Date : 2024-11-01 Epub Date: 2024-08-28 DOI:10.1007/s41669-024-00520-8

Danny Gibson, Neil Branscombe, Neil Martin, Andrew Menzies-Gow, Priya Jain, Katherine Padgett, Florian Yeates

{"title":"Modelling Adverse Events in Patients Receiving Chronic Oral Corticosteroids in the UK.","authors":"Danny Gibson, Neil Branscombe, Neil Martin, Andrew Menzies-Gow, Priya Jain, Katherine Padgett, Florian Yeates","doi":"10.1007/s41669-024-00520-8","DOIUrl":null,"url":null,"abstract":"Background: Oral corticosteroids (OCS) are effective anti-inflammatory agents used across a range of conditions. However, substantial evidence associates their use with increased risks for adverse events (AEs), causing high burden on healthcare resources. Emerging biologics present as alternative agents, enabling the reduction of OCS use. However, current modelling approaches may underestimate their effects by not capturing OCS-sparing effects. In this study, we present a modelling approach designed to capture the health economic benefits of OCS-sparing regimens and agents.Methods: We developed a disease-agnostic model using a UK health technology assessment (HTA) perspective, with discounting of 3.5% for costs and outcomes, a lifetime horizon, and 4-week cycle length. The model structure included type 2 diabetes mellitus, established cardiovascular disease, and osteoporosis as key AEs and drivers of morbidity and mortality, as well as capturing transient events. Quality-adjusted life-years (QALYs), life-years, and costs were determined for OCS-only and OCS-sparing treatment arms. Outcomes were determined using baseline 50% OCS-sparing, considering several OCS average daily doses (5, 10, 15 mg).Results: A treatment regimen with 50% OCS dose-sparing led to lifetime incremental cost savings per patient of £1107 (95% confidence interval £1014-£1229) at 5 mg, £2403 (£2203-£2668) at 10 mg, and £19,501 (£748-£51,836) at 15 mg. Patients also gained 0.033 (0.030-0.036) to 0.356 (0.022-2.404) QALYs dependent on dose. The benefits of OCS sparing were long-term, plateauing after 35-40 years of treatment.Conclusions: We present a modelling approach that captures additional long-term health economic benefits from OCS sparing that would otherwise be missed from current modelling approaches. These results may help inform future decision making for emerging OCS-sparing therapeutics by comparing them against the cost of such treatments.","PeriodicalId":19770,"journal":{"name":"PharmacoEconomics Open","volume":null,"pages":null},"PeriodicalIF":2.0000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11499505/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"PharmacoEconomics Open","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s41669-024-00520-8","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/8/28 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"ECONOMICS","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Oral corticosteroids (OCS) are effective anti-inflammatory agents used across a range of conditions. However, substantial evidence associates their use with increased risks for adverse events (AEs), causing high burden on healthcare resources. Emerging biologics present as alternative agents, enabling the reduction of OCS use. However, current modelling approaches may underestimate their effects by not capturing OCS-sparing effects. In this study, we present a modelling approach designed to capture the health economic benefits of OCS-sparing regimens and agents.

Methods: We developed a disease-agnostic model using a UK health technology assessment (HTA) perspective, with discounting of 3.5% for costs and outcomes, a lifetime horizon, and 4-week cycle length. The model structure included type 2 diabetes mellitus, established cardiovascular disease, and osteoporosis as key AEs and drivers of morbidity and mortality, as well as capturing transient events. Quality-adjusted life-years (QALYs), life-years, and costs were determined for OCS-only and OCS-sparing treatment arms. Outcomes were determined using baseline 50% OCS-sparing, considering several OCS average daily doses (5, 10, 15 mg).

Results: A treatment regimen with 50% OCS dose-sparing led to lifetime incremental cost savings per patient of £1107 (95% confidence interval £1014-£1229) at 5 mg, £2403 (£2203-£2668) at 10 mg, and £19,501 (£748-£51,836) at 15 mg. Patients also gained 0.033 (0.030-0.036) to 0.356 (0.022-2.404) QALYs dependent on dose. The benefits of OCS sparing were long-term, plateauing after 35-40 years of treatment.

Conclusions: We present a modelling approach that captures additional long-term health economic benefits from OCS sparing that would otherwise be missed from current modelling approaches. These results may help inform future decision making for emerging OCS-sparing therapeutics by comparing them against the cost of such treatments.

查看原文本刊更多论文

英国慢性口服皮质类固醇患者不良事件模型。

背景：口服皮质类固醇（OCS）是一种有效的抗炎药物，可用于多种疾病。然而，大量证据表明，使用这些药物会增加不良事件（AEs）的风险，给医疗资源造成沉重负担。新出现的生物制剂可作为替代药物，从而减少 OCS 的使用。然而，目前的建模方法可能会低估它们的效果，因为无法捕捉到OCS的节约效应。在本研究中，我们提出了一种建模方法，旨在捕捉节省 OCS 治疗方案和药物的卫生经济效益：方法：我们从英国卫生技术评估（HTA）的角度建立了一个疾病诊断模型，成本和结果的贴现率为 3.5%，周期为 4 周。模型结构包括 2 型糖尿病、已确诊的心血管疾病和骨质疏松症，将其作为主要的 AEs 以及发病率和死亡率的驱动因素，并捕捉瞬时事件。确定了纯OCS治疗组和OCS辅助治疗组的质量调整生命年（QALYs）、生命年和成本。考虑到几种OCS日均剂量（5、10、15毫克），以50%OCS保留率为基线确定结果：结果：采用OCS剂量节省50%的治疗方案，每位患者终生可节省的增量成本为：5 mg时1107英镑（95%置信区间1014-1229英镑），10 mg时2403英镑（2203-2668英镑），15 mg时19501英镑（748-51836英镑）。根据剂量的不同，患者还可获得 0.033（0.030-0.036）至 0.356（0.022-2.404）QALY。节省OCS的益处是长期性的，在治疗35-40年后趋于稳定：我们提出了一种建模方法，该方法可以捕捉到疏用脑脊液带来的额外长期健康经济效益，而目前的建模方法可能会忽略这些效益。这些结果可通过比较新出现的疏通脑脊液疗法的成本，为未来的决策提供参考。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

PharmacoEconomics Open Multiple-

CiteScore

3.50

自引率

0.00%

发文量

审稿时长

8 weeks

期刊介绍： PharmacoEconomics - Open focuses on applied research on the economic implications and health outcomes associated with drugs, devices and other healthcare interventions. The journal includes, but is not limited to, the following research areas:Economic analysis of healthcare interventionsHealth outcomes researchCost-of-illness studiesQuality-of-life studiesAdditional digital features (including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations) can be published with articles; these are designed to increase the visibility, readership and educational value of the journal’s content. In addition, articles published in PharmacoEconomics -Open may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand important medical advances.All manuscripts are subject to peer review by international experts. Letters to the Editor are welcomed and will be considered for publication.