Cost-effectiveness analysis of infliximab versus CinnoRA in the treatment of moderate to severe ulcerative colitis in Iranian patients

IF 1.1 Q4 IMMUNOLOGY
Meysam Olfatifar, H. Asadzadeh Aghdaei, Ayda Hasanpour Dehkordi, S. Shahrokh, M. Pourhoseingholi, H. Balaii, Mohsen Rajabnia, M. Ivanchuk, P. Ivanchuk, Saeed Hashemi Nazari, S. Sabour, P. Rohani, G. Mehralian, S. Khodakarim, B. Hatami, Habib Malekpour, Ghazal Sherkat, M. Zali, Sajjad Rahimi Pordanjani
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Abstract

Introduction: As two biological agents, infliximab (IFX) and biosimilar adalimumab (CinnoRA®) are routinely used in the clinical management of ulcerative colitis (UC) in Iran. Objectives: This study was done to evaluate the cost-effectiveness of IFX versus CinnoRA for the treatment of moderate-to-severe UC patients. Patients and Methods: To accomplish this, we developed a hybrid decision-tree/microsimulation (MS) approach for modeling UC’s natural history. We populated our model with available data on probabilities, costs, utilities / disutilities, and emergent adverse effects. Costs were reported in Iranian Rial (IRR) and in April 2021 US dollars ($). One-way and multiple sensitivity analyses were used to determine the uncertainty of the model’s parameters. Results: For five, 10, and lifetime horizon times, patients on IFX received slightly more quality-adjusted life-year (QALY) per year in remission and experienced about 3 to 5 times less surgery than CinnoRA patients. With willingness-to-pay (WTP) thresholds of 1800 ($7826.08), 820($3565.21), and 520 ($2260.86) million IRR for these horizon times, IFX was cost-effective with 100% certainty. Our findings were highly sensitive to the number of adverse effects. Conclusion: Our results demonstrated that IFX is more effective and more costly than CinnoRA, and if we ignore the predicted surgeries, CinnoRA is nearly as effective as IFX. However, these findings should be cautiously interpreted without a robust clinical trial of CinnoRA in UC patients. Since the impact of CinnoRA may have been over/underestimated.
英夫利昔单抗与CinnoRA治疗伊朗患者中重度溃疡性结肠炎的成本-效果分析
简介:作为两种生物制剂,英夫利昔单抗(IFX)和生物类似物阿达木单抗(CinnoRA®)在伊朗常规用于溃疡性结肠炎(UC)的临床治疗。目的:本研究旨在评估IFX与CinnoRA治疗中重度UC患者的成本效益。患者和方法:为了实现这一点,我们开发了一种混合决策树/微模拟(MS)方法来模拟UC的自然史。我们用概率、成本、效用/不效用和紧急不良影响的可用数据填充了我们的模型。成本以伊朗里亚尔(IRR)和2021年4月的美元($)报告。采用单向和多灵敏度分析来确定模型参数的不确定性。结果:在5次、10次和终身期内,接受IFX治疗的患者在病情缓解时每年接受的质量调整生命年(QALY)略多,手术次数比CinnoRA患者少约3至5倍。在这些时间段内,支付意愿(WTP)阈值分别为1800(7826.08美元)、820(3565.21美元)和520(2260.86美元)百万内部收益率,IFX具有100%的确定性,具有成本效益。我们的研究结果对不良反应的数量高度敏感。结论:我们的研究结果表明,IFX比CinnoRA更有效,成本更高,如果我们忽略预测的手术,CinnoRA几乎和IFX一样有效。然而,在没有对UC患者进行CinnoRA的有力临床试验的情况下,应谨慎解释这些发现。由于CinnoRA的影响可能被高估/低估了。
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
CiteScore
1.70
自引率
0.00%
发文量
65
审稿时长
3 weeks
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