意大利维多单抗作为溃疡性结肠炎一线晚期疗法与阿达木单抗治疗序列的成本效益对比。

IF 2 Q2 ECONOMICS
PharmacoEconomics Open Pub Date : 2024-09-01 Epub Date: 2024-06-11 DOI:10.1007/s41669-024-00497-4
Jonathan Salcedo, Daniel Hill-McManus, Chloë Hardern, Oyin Opeifa, Raffaella Viti, Ludovica Siviero, Antonio Saverio Roscini, Gennaro Di Martino
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引用次数: 0

摘要

背景:如今,治疗溃疡性结肠炎的方法有很多,这给选择最有效和最具成本效益的治疗方案带来了挑战。抗肿瘤坏死因子α(TNFα)治疗类药物以及维多珠单抗被广泛使用,并被治疗指南认可为一线治疗方案。本研究的目的是比较在意大利治疗中度至重度活动性溃疡性结肠炎时,使用维多珠单抗和抗TNFα治疗药物阿达木单抗的治疗序列的成本效益:方法:我们建立了一个成本效益模型,从成本和质量调整生命年(QALYs)的角度对意大利国家医疗服务体系内的治疗顺序进行了终生比较。分析的重点是韦多珠单抗和阿达木单抗的相对定位,将具有里程碑意义的头对头 VARSITY 临床试验结果作为关键输入。通过一系列敏感性和情景分析,研究了结果的稳健性:结果:与先使用阿达木单抗再使用维多珠单抗的一线先进疗法相比,先使用维多珠单抗再使用阿达木单抗的策略具有更高的成本和健康效益。增量成本效益比为16,146欧元/QALY,该结果对与高不确定性领域相关的投入的变化是稳健的:这项经济评估估计,与一线阿达木单抗序列相比,维多珠单抗作为一线晚期疗法在33,004欧元/QALY的临界值下具有成本效益的可能性为94%。利用临床试验证据为二线疗法的疗效提供依据,估计抗肿瘤坏死因子α疗法的疗效不会因接触维多珠单抗而大幅降低。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cost-Effectiveness of Vedolizumab as a First-Line Advanced Therapy Versus Adalimumab Treatment Sequences for Ulcerative Colitis in Italy.

Background: Today, there are many treatment options available for the management of ulcerative colitis, creating challenges in selecting the most efficacious and cost-effective treatment sequences. Treatments in the anti-tumor necrosis factor alpha (TNFα) therapeutic class, as well as vedolizumab, are widely used and endorsed as first-line options according to treatment guidelines. The aim of this study was to compare treatment sequences involving vedolizumab and the anti-TNFα treatment adalimumab in terms of cost-effectiveness in the treatment of moderately to severely active ulcerative colitis in Italy.

Methods: A cost-effectiveness model comparing treatment sequences within the Italian National Health Service in terms of costs and quality-adjusted life years (QALYs) with a lifetime horizon was developed. The analysis focused on the relative positioning of vedolizumab and adalimumab, leveraging the results of the landmark head-to-head VARSITY clinical trial as key inputs. The robustness of the results was investigated through a range of sensitivity and scenario analyses.

Results: The strategy of vedolizumab as a first-line advanced therapy followed by adalimumab was associated with higher costs and health benefits compared with first-line adalimumab followed by vedolizumab. The incremental cost-effectiveness ratio was €16,146/QALY, which was found to be robust to changes to inputs associated with areas of high uncertainty.

Conclusion: This economic evaluation estimated a 94% probability that vedolizumab as a first-line advanced therapy is cost-effective at a threshold of €33,004/QALY when compared with first-line adalimumab sequences. Using clinical trial evidence to inform the efficacy of second-line treatments estimated that the effectiveness of anti-TNFα treatments is not substantially reduced by vedolizumab exposure.

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来源期刊
CiteScore
3.50
自引率
0.00%
发文量
64
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.
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