| Title: |
Evaluating the Cost-Effectiveness of Early Compared with Late or No Biologic Treatment to Manage Crohn’s Disease using Real-World Data |
| Authors: |
Pillai, Nadia; Lupatsch, Judith E; Dusheiko, Mark; Schwenkglenks, Matthias; Maillard, Michel; Sutherland, C Simone; Pittet, Valérie E H; Anderegg, Claudia; Bauerfeind, Peter; Beglinger, Christoph; Begré, Stefan; Belli, Dominique; Bengoa, José M; Biedermann, Luc; Bigler, Beat; Binek, Janek; Blattmann, Mirjam; Boehm, Stephan; Borovicka, Jan; Braegger, Christian P; Brunner, Nora; Bühr, Patrick; Burnand, Bernard; Burri, Emanuel; Buyse, Sophie; Cremer, Matthias; Criblez, Dominique H; de Saussure, Philippe; Degen, Lukas; Delarive, Joakim; Doerig, Christopher; Dora, Barbara; Dorta, Gian; Egger, Mara; Ehmann, Tobias; El-Wafa, Ali; Engelmann, Matthias; Ezri, Jessica; Felley, Christian; Fliegner, Markus; Fournier, Nicolas; Fraga, Montserrat; Frei, Pascal; Frei, Remus; Fried, Michael; Froehlich, Florian; Funk, Christian; Furlano, Raoul Ivano; Gallot-Lavallée, Suzanne; Geyer, Martin |
| Contributors: |
Swiss National Science Foundation |
| Source: |
Journal of Crohn's and Colitis ; volume 14, issue 4, page 490-500 ; ISSN 1873-9946 1876-4479 |
| Publisher Information: |
Oxford University Press (OUP) |
| Publication Year: |
2019 |
| Description: |
Background and Aims We evaluated the cost-effectiveness of early [≤2 years after diagnosis] compared with late or no biologic initiation [starting biologics >2 years after diagnosis or no biologic use] for adults with Crohn’s disease in Switzerland. Methods We developed a Markov cohort model over the patient’s lifetime, from the health system and societal perspectives. Transition probabilities, quality of life, and costs were estimated using real-world data. Propensity score matching was used to ensure comparability between patients in the early [intervention] and late/no [comparator] biologic initiation strategies. The incremental cost-effectiveness ratio [ICER] per quality-adjusted life year [QALY] gained is reported in Swiss francs [CHF]. Sensitivity and scenario analyses were performed. Results Total costs and QALYs were higher for the intervention [CHF384 607; 16.84 QALYs] compared with the comparator [CHF340 800; 16.75 QALYs] strategy, resulting in high ICERs [health system: CHF887 450 per QALY; societal: CHF449 130 per QALY]. In probabilistic sensitivity analysis, assuming a threshold of CHF100 000 per QALY, the probability that the intervention strategy was cost-effective was 0.1 and 0.25 from the health system and societal perspectives, respectively. In addition, ICERs improved when we assumed a 30% reduction in biologic prices [health system: CHF134 502 per QALY; societal: intervention dominant]. Conclusions Early biologic use was not cost-effective, considering a threshold of CHF100 000 per QALY compared with late/no biologic use. However, early identification of patients likely to need biologics and future drug price reductions through increased availability of biosimilars may improve the cost-effectiveness of an early treatment approach. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1093/ecco-jcc/jjz169 |
| DOI: |
10.1093/ecco-jcc/jjz169/33212169/jjz169.pdf |
| Availability: |
https://doi.org/10.1093/ecco-jcc/jjz169; http://academic.oup.com/ecco-jcc/advance-article-pdf/doi/10.1093/ecco-jcc/jjz169/33212169/jjz169.pdf; http://academic.oup.com/ecco-jcc/article-pdf/14/4/490/33282156/jjz169.pdf |
| Rights: |
https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model |
| Accession Number: |
edsbas.98085AFB |
| Database: |
BASE |