IVT-AFL 2q8 versus ranibizumab 0.5q4, and an indirect comparison of IVT-AFL 2q8 with ranibizumab 0.5PRN data. A de novo health economic model combined these clinical inputs with Dutch-specific costs associated with treatment, monitoring, and indirect caregiving, and utility inputs relevant to a Dutch population. Total quality-adjusted life-years (QALYs) and costs were calculated over a 15-year horizon. Uncertainty around the outcomes was tested through sensitivity analyses. Results: Compared with ranibizumab 0.5q4, a 2-year treatment IVT-AFL is associated with a significantly lower cost of € 7337 (95% CI: € 7248-€ 7435) over a 15-year horizon. There is no significant difference in QALYs (-0.0027 [95% CI: -0.0057 to 0.0001]). IVT-AFL 2q8 also has significantly lower total costs than ranibizumab 0.5PRN (€ 2450 [95% CI: € 2349-€ 2549]), with a nonsignificant gain of 0.0007 QALYS (95% CI: -0.0023 to 0.0036). Probabilistic analyses show that, due to its lower costs, IVT-AFL 2q8 treatment had an estimated > 99% probability of being cost-effective compared with both of the ranibizumab treatment strategies at a willingness-to-pay threshold of € 20,000 per QALY, the proposed informal Dutch threshold. The univariate analyses did not alter the conclusions. ConClusions: The analysis showed that IVT-AFL 2q8 treatment is associated with cost savings versus ranibizumab 0.5q4 or 0.5PRN. There is no significant difference in total QALYs between the treatments. Due to lower overall costs, IVT-AFL is a costeffective treatment option for wAMD patients in the Netherlands.
A569data. Results were presented as incremental cost-effectiveness ratios (ICERs) per PASI90 16-week response. Both one-way and probabilistic sensitivity analyses were performed to test the robustness of the results. Results: Combining Secukinumab 300 significantly greater effectiveness in terms of PASI90 response compared with Ustekinumab and Etanercept with the total 2-year costs accrued in each therapeutic option, the base-case ICERs per PASI90 response of Secukinumab 300 versus Ustekinumab 90, Ustekinumab 45, Ustekinumab 90&45 weighted and Etanercept were € 9,543, € 13,316, € 11,941 and € 17,448, respectively. These ICERs lie well beneath the defined willingness-to-pay threshold of € 36,000 in Greece (twice the per capita income) indicating that Secukinumab 300 is cost-effective versus Ustekinumab and Etanercept in moderate-to-severe plaque psoriasis. The sensitivity analyses confirmed the robustness of the model results. ConClusions: Secukinumab was found to be cost-effective in terms of PASI90 response at 16-weeks compared with both Ustekinumab and Etanercept for the treatment of moderate-to-severe plaque psoriasis in Greece.
to be 194.4 compared with 194.1 for the Alendronic acid group, which resulted in a difference of 0.33 QALYs. The total costs for the Zoledronic acid group and Alendronic acid group were LE 215,232 and LE 215,087 respectively. These costs yielded an ICER of LE 435 for the Zoledronic acid group. The odds ratio of zoledronic acid on vertebral & non-vertebral fractures was found to have the greatest impact on the results. ConClusions: Compared with our willingness-to-pay threshold stated by world health organization for middle and lower income countries, Zoledronic acid is cost-effective; and most likely to result in an ICER lower than the threshold limit. Thus, the new treatment (Zoledronic acid) should be recommended in the Ministry of health list.
Objectives: A cost-utility model was developed to assess the impact of placing apremilast, a new oral treatment, before biologics for patients with active psoriatic arthritis (PsA) who failed to respond to or are intolerant of conventional disease-modifying antirheumatic drugs (DMARDs) from a Spain payer perspec-
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