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Cost-utility of biological treatment sequences for luminal Crohn's disease in Europe
Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary.
Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary.
Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary.
1st Department of Medicine, Semmelweis University, Budapest, Hungary.
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2017 (English)In: Expert review of pharmacoeconomics & outcomes research, ISSN 1473-7167, E-ISSN 1744-8379, 1-10 p.Article in journal (Refereed) Epub ahead of print
Abstract [en]

BACKGROUND: This study aims to compare the cost-effectiveness of treatment sequences with available biologics, including adalimumab (ADA), biosimilar infliximab (bsIFX), originator infliximab (IFX) and vedolizumab (VEDO) for luminal Crohn's disease in nine European countries.

METHODS: A Markov-model was constructed to simulate five-year medical costs and quality-adjusted life years (QALYs). Data on clinical efficacy were obtained from randomised controlled trials. Country-specific unit costs, discount rates and a third-party payer perspective were applied.

RESULTS: The bsIFX versus conventional therapy resulted in the most favourable incremental cost-utility ratios (ICURs) ranging from €34,580 (Hungary) to €77,062/QALY (Sweden). Compared to bsIFX, the bsIFX-ADA sequence was more cost-effective than the bsIFX-VEDO sequence with ICURs varying between €70,277 (France) and €162,069/QALY (Germany). The ICURs of the bsIFX-ADA-VEDO sequence versus the bsIFX-ADA strategy were between €206,266 (The Netherlands) and €363,232/QALY (Spain).

CONCLUSION: We are the first to compare cost-effectiveness of multiple biological sequences for luminal Crohn's disease. Based on our findings, bsIFX can be recommended as a first-line treatment in patients unresponsive to conventional treatments. While biological sequences only slightly differ in their associated health gains, their costs vary greatly. The bsIFX-ADA-VEDO seems to be the most cost-effective sequence of the available biologics across Europe.

Place, publisher, year, edition, pages
Oxfordshire, United Kingdom: Taylor & Francis, 2017. 1-10 p.
Keyword [en]
Adalimumab, Crohn’s disease, biosimilar infliximab, cost-effectiveness, inflammatory bowel diseases, infliximab, vedolizumab
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
URN: urn:nbn:se:oru:diva-60913DOI: 10.1080/14737167.2017.1322509PubMedID: 28434387Scopus ID: 2-s2.0-85018171573OAI: oai:DiVA.org:oru-60913DiVA: diva2:1142192
Note

Funding agencies:

Pfizer Hospira UK Ltd

Available from: 2017-09-18 Created: 2017-09-18 Last updated: 2017-09-27Bibliographically approved

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