OBJECTIVE:Adalimumab is a fully human, monoclonal antibody clinically effective for the treatment of active Crohn's disease. The cost-effectiveness of adalimumab versus conventional, nonbiologic pharmacotherapies is unknown. This study evaluated the cost-effectiveness of adalimumab versus conventional, nonbiologic pharmacotherapies in the maintenance of Crohn's disease. METHODS: Trial data from two randomized controlled studies [Crohn's Trial of the Fully Human Antibody Adalimumab for Remission Maintenance (CHARM) and CLinical Assessment of Adalimumab Safety and Efficacy Studied as Induction Therapy in Crohn's Disease (CLASSIC I)] were analyzed within a cost-utility framework using a 1-year horizon from the perspective of the National Health Service (UK). The treatment efficacy and use for the adalimumab arm were based on observations from CHARM. A regression model used data from CLASSIC I to predict efficacy in patients who received nonbiologic pharmacotherapy. Unit costs of drugs, hospitalization, and other medical resources were derived from the literature. Primary standard gamble-calculated data were used to derive health-utility estimates. RESULTS: Compared with conventional, nonbiologic pharmacotherapy, adalimumab seemed to be cost-effective for the treatment of patients with severe disease and moderate-to-severe disease. The 56-week incremental cost-effectiveness ratio was 16 064 UK pounds/quality-adjusted life-year and 33 731 UK pounds/quality-adjusted life-year for severe and moderate-to-severe groups, respectively. Sensitivity analyses showed that the findings were robust. In the treatment of patients over their lifetimes, the incremental cost-effectiveness ratio was 6550 UK pounds/quality-adjusted life-year and 17 873 UK pounds/quality-adjusted life-year for patients with severe Crohn's disease and those with moderate-to-severe Crohn's disease, respectively. CONCLUSION:Adalimumab maintenance therapy seems to be cost-effective versus conventional, nonbiologic therapies for the maintenance of remission in patients with active Crohn's disease.
RCT Entities:
OBJECTIVE:Adalimumab is a fully human, monoclonal antibody clinically effective for the treatment of active Crohn's disease. The cost-effectiveness of adalimumab versus conventional, nonbiologic pharmacotherapies is unknown. This study evaluated the cost-effectiveness of adalimumab versus conventional, nonbiologic pharmacotherapies in the maintenance of Crohn's disease. METHODS: Trial data from two randomized controlled studies [Crohn's Trial of the Fully Human Antibody Adalimumab for Remission Maintenance (CHARM) and CLinical Assessment of Adalimumab Safety and Efficacy Studied as Induction Therapy in Crohn's Disease (CLASSIC I)] were analyzed within a cost-utility framework using a 1-year horizon from the perspective of the National Health Service (UK). The treatment efficacy and use for the adalimumab arm were based on observations from CHARM. A regression model used data from CLASSIC I to predict efficacy in patients who received nonbiologic pharmacotherapy. Unit costs of drugs, hospitalization, and other medical resources were derived from the literature. Primary standard gamble-calculated data were used to derive health-utility estimates. RESULTS: Compared with conventional, nonbiologic pharmacotherapy, adalimumab seemed to be cost-effective for the treatment of patients with severe disease and moderate-to-severe disease. The 56-week incremental cost-effectiveness ratio was 16 064 UK pounds/quality-adjusted life-year and 33 731 UK pounds/quality-adjusted life-year for severe and moderate-to-severe groups, respectively. Sensitivity analyses showed that the findings were robust. In the treatment of patients over their lifetimes, the incremental cost-effectiveness ratio was 6550 UK pounds/quality-adjusted life-year and 17 873 UK pounds/quality-adjusted life-year for patients with severe Crohn's disease and those with moderate-to-severe Crohn's disease, respectively. CONCLUSION:Adalimumab maintenance therapy seems to be cost-effective versus conventional, nonbiologic therapies for the maintenance of remission in patients with active Crohn's disease.
Authors: Antonio Di Sabatino; Lucio Liberato; Monia Marchetti; Paolo Biancheri; Gino R Corazza Journal: Intern Emerg Med Date: 2011-10 Impact factor: 3.397
Authors: Fanni Rencz; Márta Péntek; Martin Bortlik; Edyta Zagorowicz; Tibor Hlavaty; Andrzej Śliwczyński; Mihai M Diculescu; Limas Kupcinskas; Krisztina B Gecse; László Gulácsi; Peter L Lakatos Journal: World J Gastroenterol Date: 2015-02-14 Impact factor: 5.742
Authors: Yeohan Song; Julie H Y Tai; Sarah M Bartsch; Richard K Zimmerman; Robert R Muder; Bruce Y Lee Journal: Vaccine Date: 2012-03-29 Impact factor: 3.641
Authors: R W Stidham; T C H Lee; P D R Higgins; A R Deshpande; D A Sussman; A G Singal; B J Elmunzer; S D Saini; S Vijan; A K Waljee Journal: Aliment Pharmacol Ther Date: 2014-04-20 Impact factor: 8.171
Authors: Emily K Wright; Michael A Kamm; Peter Dr Cruz; Amy L Hamilton; Kathryn J Ritchie; Sally J Bell; Steven J Brown; William R Connell; Paul V Desmond; Danny Liew Journal: World J Gastroenterol Date: 2016-04-14 Impact factor: 5.742