| 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; Swiss IBD Cohort Study group |
| Contributors: |
Petit, Laëtitia Marie |
| Source: |
ISSN: 1873-9946 ; Journal of Crohn's and colitis, vol. 14, no. 4 (2020) p. 490-500. |
| Publication Year: |
2020 |
| Collection: |
Université de Genève: Archive ouverte UNIGE |
| Subject Terms: |
info:eu-repo/classification/ddc/618; Crohn’s disease; Arly biologic initiation; Cost-effectiveness; Adult; Biological Products / economics; Biological Products / therapeutic use; Biosimilar Pharmaceuticals / economics; Biosimilar Pharmaceuticals / pharmacology; Cost-Benefit Analysis; Crohn Disease / diagnosis; Crohn Disease / economics; Crohn Disease / psychology; Crohn Disease / therapy; Drug Costs; Female; Humans; Male; Needs Assessment; Quality of Life; Quality-Adjusted Life Years; Switzerland; Time-to-Treatment / economics; Time-to-Treatment / statistics & numerical data |
| 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 |
| Relation: |
info:eu-repo/semantics/altIdentifier/pmid/31630164; unige:159485 |
| Availability: |
https://archive-ouverte.unige.ch/unige:159485 |
| Rights: |
info:eu-repo/semantics/openAccess |
| Accession Number: |
edsbas.C0723338 |
| Database: |
BASE |