INTRODUCTION: Patients with active rheumatoid arthritis (RA) often have inadequately controlled symptoms and are unable to achieve remission or low disease activity despite aggressive treatment. This results in irreversible joint damage, adversely affecting patients' physical and social functioning. The objective was to estimate the cost-effectiveness of repository corticotropin injection (RCI) versus standard of care (SoC) in patients with active RA from the United States (US) payer and societal perspectives over two to three years. METHODS: An individual-level microsimulation was developed to generate individual trajectories for patients with RA, using data from a published Phase 4 trial of RCI. These trajectories report a patient's disease pathway and associated cost and quality-of-life outcomes. The incremental cost-effectiveness ratio (ICER) of RCI versus SoC was assessed using the literature-derived direct medical and indirect costs, and quality-adjusted life-years (QALY) derived from a Phase 4 trial of RCI. The uncertainty in base case estimates of the parameters was evaluated in the sensitivity analysis. RESULTS: Over two years, RCI has an incremental QALY gain of 1.591 and incremental cost of $183,965 and $117,443 from payer and societal perspective, respectively, resulting in an ICER of $115,629/QALY and $73,817/QALY compared to SoC. Over three years, RCI has an incremental QALY gain of 2.336 and incremental cost of $202,315 and $104,506 from payer and societal perspective, respectively, resulting in an ICER of $86,607/QALY and $44,737/QALY compared to SoC. Results from the probabilistic sensitivity analysis are consistent with those of the base case model. CONCLUSION: RCI is a cost-effective strategy for patients with persistently active RA who are previously treated with disease-modifying anti-rheumatic drugs and corticosteroids compared to SoC over two to three years from the payer and societal perspectives at a US willingness-to-pay threshold of $150,000/QALY. Further, the economic benefit of RCI is realized with improvement in a patient's clinical and health outcomes.
INTRODUCTION: Patients with active rheumatoid arthritis (RA) often have inadequately controlled symptoms and are unable to achieve remission or low disease activity despite aggressive treatment. This results in irreversible joint damage, adversely affecting patients' physical and social functioning. The objective was to estimate the cost-effectiveness of repository corticotropin injection (RCI) versus standard of care (SoC) in patients with active RA from the United States (US) payer and societal perspectives over two to three years. METHODS: An individual-level microsimulation was developed to generate individual trajectories for patients with RA, using data from a published Phase 4 trial of RCI. These trajectories report a patient's disease pathway and associated cost and quality-of-life outcomes. The incremental cost-effectiveness ratio (ICER) of RCI versus SoC was assessed using the literature-derived direct medical and indirect costs, and quality-adjusted life-years (QALY) derived from a Phase 4 trial of RCI. The uncertainty in base case estimates of the parameters was evaluated in the sensitivity analysis. RESULTS: Over two years, RCI has an incremental QALY gain of 1.591 and incremental cost of $183,965 and $117,443 from payer and societal perspective, respectively, resulting in an ICER of $115,629/QALY and $73,817/QALY compared to SoC. Over three years, RCI has an incremental QALY gain of 2.336 and incremental cost of $202,315 and $104,506 from payer and societal perspective, respectively, resulting in an ICER of $86,607/QALY and $44,737/QALY compared to SoC. Results from the probabilistic sensitivity analysis are consistent with those of the base case model. CONCLUSION: RCI is a cost-effective strategy for patients with persistently active RA who are previously treated with disease-modifying anti-rheumatic drugs and corticosteroids compared to SoC over two to three years from the payer and societal perspectives at a US willingness-to-pay threshold of $150,000/QALY. Further, the economic benefit of RCI is realized with improvement in a patient's clinical and health outcomes.
Authors: E van der Kooi; N B Klarenbeek; M Güler-Yüksel; P J S M Kerstens; P A H M van der Lubbe; M L Westedt; S ten Wolde; T W J Huizinga; B A C Dijkmans; C F Allaart Journal: Ann Rheum Dis Date: 2010-11-29 Impact factor: 19.103
Authors: Jasvinder A Singh; Kenneth G Saag; S Louis Bridges; Elie A Akl; Raveendhara R Bannuru; Matthew C Sullivan; Elizaveta Vaysbrot; Christine McNaughton; Mikala Osani; Robert H Shmerling; Jeffrey R Curtis; Daniel E Furst; Deborah Parks; Arthur Kavanaugh; James O'Dell; Charles King; Amye Leong; Eric L Matteson; John T Schousboe; Barbara Drevlow; Seth Ginsberg; James Grober; E William St Clair; Elizabeth Tindall; Amy S Miller; Timothy McAlindon Journal: Arthritis Care Res (Hoboken) Date: 2015-11-06 Impact factor: 4.794
Authors: Kemjika O Onuoha; Max Solow; Jared M Newman; Nipun Sodhi; Robert Pivec; Anton Khlopas; Assem A Sultan; Morad Chughtai; Neil V Shah; Jaiben George; Michael A Mont Journal: Ann Transl Med Date: 2017-12
Authors: Josef S Smolen; Robert Landewé; Johannes Bijlsma; Gerd Burmester; Katerina Chatzidionysiou; Maxime Dougados; Jackie Nam; Sofia Ramiro; Marieke Voshaar; Ronald van Vollenhoven; Daniel Aletaha; Martin Aringer; Maarten Boers; Chris D Buckley; Frank Buttgereit; Vivian Bykerk; Mario Cardiel; Bernard Combe; Maurizio Cutolo; Yvonne van Eijk-Hustings; Paul Emery; Axel Finckh; Cem Gabay; Juan Gomez-Reino; Laure Gossec; Jacques-Eric Gottenberg; Johanna M W Hazes; Tom Huizinga; Meghna Jani; Dmitry Karateev; Marios Kouloumas; Tore Kvien; Zhanguo Li; Xavier Mariette; Iain McInnes; Eduardo Mysler; Peter Nash; Karel Pavelka; Gyula Poór; Christophe Richez; Piet van Riel; Andrea Rubbert-Roth; Kenneth Saag; Jose da Silva; Tanja Stamm; Tsutomu Takeuchi; René Westhovens; Maarten de Wit; Désirée van der Heijde Journal: Ann Rheum Dis Date: 2017-03-06 Impact factor: 19.103