Aggregate Distributional Cost-Effectiveness Analysis of Biologics for the Treatment of Ankylosing Spondylitis in Chile.

IF 3.1 4区 医学 Q1 ECONOMICS
Magdalena Walbaum, Nicolas Jana-Valencia
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Abstract

Background and objective: Ankylosing spondylitis is a complex rheumatic disease, characterised by chronic and progressive inflammation of the spine, causing an important health and economic burden for the person with the condition. Evidence shows the unequal impact of the disease in different groups of people, with a higher burden for lower socioeconomic groups. The objective of this study is to evaluate the impact of the use of biologics for the treatment of ankylosing spondylitis on health inequities in Chile.

Methods: We conducted an aggregate distributional cost-effectiveness analysis. Data on health outcomes and costs were derived from a cost-effectiveness model of secukinumab, etanercept, certolizumab pegol, infliximab, adalimumab and golimumab versus treatment as usual for the treatment of ankylosing spondylitis from the Chilean healthcare system perspective. Health gains and health opportunity costs were distributed across socioeconomic subgroups. Health and equity impacts, measured using the Atkinson index, were assessed on an equity-efficiency impact plane.

Results: All treatments had a positive impact on equity relative to treatment as usual. At an opportunity cost threshold of 1 Gross Domestic Product per capita/quality-adjusted life-year, secukinumab improved societal welfare irrespective of the Atkinson index value. When varying thresholds (2 and 3 Gross Domestic Product), all assessed technologies contributed to an increase in societal welfare, regardless of the Atkinson index.

Conclusions: Biologic treatment for ankylosing spondylitis, such as secukinumab, may reduce health inequity in the Chilean population. An aggregate distributional cost-effectiveness analysis framework is feasible to implement alongside a cost-effectiveness analysis in the context of the Chilean healthcare system to provide additional information of equity impacts for health technology assessment recommendations and policy making.

智利治疗强直性脊柱炎生物制剂的总体分布成本-效果分析。
背景和目的:强直性脊柱炎是一种复杂的风湿性疾病,以脊柱慢性进行性炎症为特征,对患者造成重要的健康和经济负担。有证据表明,该疾病对不同人群的影响不平等,社会经济地位较低的群体负担更重。本研究的目的是评估使用生物制剂治疗强直性脊柱炎对智利卫生不公平现象的影响。方法:我们进行了总体分配成本-效果分析。健康结果和成本数据来自智利医疗保健系统角度的成本-效果模型,该模型将secukinumab、依那西普、certolizumab pegol、英夫利昔单抗、阿达木单抗和戈利木单抗与常规治疗相比用于治疗强直性脊柱炎。健康收益和健康机会成本分布在社会经济亚群体中。使用阿特金森指数衡量健康和公平影响,在公平-效率影响层面进行评估。结果:与常规治疗相比,所有治疗均对公平有积极影响。在1人均国内生产总值/质量调整生命年的机会成本门槛下,无论阿特金森指数值如何,secukinumab都能改善社会福利。当不同的阈值(国内生产总值2和3)时,所有被评估的技术都对社会福利的增加做出了贡献,而不考虑阿特金森指数。结论:强直性脊柱炎的生物治疗,如secukinumab,可能会减少智利人群的健康不平等。在智利卫生保健系统的背景下,与成本效益分析一起实施总分配成本效益分析框架是可行的,可以为卫生技术评估建议和政策制定提供额外的公平影响信息。
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
Applied Health Economics and Health Policy
Applied Health Economics and Health Policy Economics, Econometrics and Finance-Economics and Econometrics
CiteScore
6.10
自引率
2.80%
发文量
64
期刊介绍: Applied Health Economics and Health Policy provides timely publication of cutting-edge research and expert opinion from this increasingly important field, making it a vital resource for payers, providers and researchers alike. The journal includes high quality economic research and reviews of all aspects of healthcare from various perspectives and countries, designed to communicate the latest applied information in health economics and health policy. While emphasis is placed on information with practical applications, a strong basis of underlying scientific rigor is maintained.
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