Intravenous and subcutaneous vedolizumab for moderately to severely active ulcerative colitis in Iran: a model-based cost-effectiveness evaluation.

IF 1.5 4区 医学 Q3 HEALTH CARE SCIENCES & SERVICES
Kimia Niksalehi, Anita Oyarhossein, Soroush Fariman, Adel Ahmadi, Behniya Azadmehr, Naeim Karimpour-Fard, Laleh Vaziri, Monireh Afzali
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引用次数: 0

Abstract

Objective: To evaluate the cost-effectiveness of intravenous and subcutaneous vedolizumab compared to infliximab for moderately to severely active ulcerative colitis (UC) from an Iranian societal perspective.

Methods: A decision-analytic cost-utility model was developed using a decision tree and a Markov model. Direct and indirect costs were calculated. Treatment effectiveness and health state utility values were extracted from published literature. Effects were estimated using quality-adjusted life-years (QALYs). Costs and QALYs were projected over a lifetime and discounted at 3% per year. Deterministic and probabilistic sensitivity analyses were performed to evaluate uncertainties.

Results: In base-case analysis, infliximab was associated with $28,888.5 costs and 15.17 QALYs. Vedolizumab was associated with 15.34 QALYs and costs of $27,916.90 for IV (induction and maintenance) and $28,200.40 for IV (induction) followed by SC (maintenance). The ICERs were estimated at -$5673.3/QALY and -$4,017.8/QALY, remaining negative across all sensitivity analyses. The cost of infliximab and vedolizumab and the probability of response to vedolizumab during maintenance were the key determinants of cost-effectiveness.

Conclusions: Vedolizumab (both IV and SC) resulted in reduced costs and improved QALYs compared to infliximab for moderate to severe UC in Iran. Therefore, we recommended including vedolizumab in the Iranian national formulary as a cost-effective treatment strategy.

静脉注射和皮下vedolizumab治疗伊朗中度至重度活动性溃疡性结肠炎:基于模型的成本-效果评估
目的:从伊朗社会的角度评估静脉注射和皮下注射vedolizumab与英夫利昔单抗治疗中度至重度活动性溃疡性结肠炎(UC)的成本效益。方法:采用决策树和马尔可夫模型建立决策分析成本-效用模型。计算了直接和间接成本。从已发表的文献中提取治疗效果和健康状态效用值。使用质量调整生命年(QALYs)评估效果。在整个生命周期中预测成本和质量年,并以每年3%的折现率计算。采用确定性和概率敏感性分析来评估不确定性。结果:在基本病例分析中,英夫利昔单抗与28,888.5美元的成本和15.17个qaly相关。Vedolizumab与15.34个qaly相关,IV(诱导和维持)和IV(诱导)随后SC(维持)的费用分别为27,916.90美元和28,200.40美元。ICERs估计为- 5673.3美元/QALY和- 4017.8美元/QALY,所有敏感性分析均为阴性。英夫利昔单抗和维多单抗的成本以及维持期间对维多单抗的反应概率是成本-效果的关键决定因素。结论:在伊朗,与英夫利昔单抗相比,Vedolizumab (IV和SC)降低了治疗中重度UC的成本,改善了QALYs。因此,我们建议将vedolizumab纳入伊朗国家处方中,作为一种具有成本效益的治疗策略。
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来源期刊
Expert Review of Pharmacoeconomics & Outcomes Research
Expert Review of Pharmacoeconomics & Outcomes Research HEALTH CARE SCIENCES & SERVICES-PHARMACOLOGY & PHARMACY
CiteScore
4.00
自引率
4.30%
发文量
68
审稿时长
6-12 weeks
期刊介绍: Expert Review of Pharmacoeconomics & Outcomes Research (ISSN 1473-7167) provides expert reviews on cost-benefit and pharmacoeconomic issues relating to the clinical use of drugs and therapeutic approaches. Coverage includes pharmacoeconomics and quality-of-life research, therapeutic outcomes, evidence-based medicine and cost-benefit research. All articles are subject to rigorous peer-review. The journal adopts the unique Expert Review article format, offering a complete overview of current thinking in a key technology area, research or clinical practice, augmented by the following sections: Expert Opinion – a personal view of the data presented in the article, a discussion on the developments that are likely to be important in the future, and the avenues of research likely to become exciting as further studies yield more detailed results Article Highlights – an executive summary of the author’s most critical points.
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