Cost Effectiveness of Tofacitinib for the Treatment of Moderate to Severe Active Ulcerative Colitis in Colombia

Abstract

Objective The aim of this study was to evaluate the cost effectiveness of tofacitinib versus other treatment options currently available in Colombia in naïve to biologics (first-line) and exposed to biologics (second-line) patients with moderate to severe active ulcerative colitis (UC). Methods A Markov model was constructed with 8-week cycles, simulating a cohort of patients in a 5-year time horizon. The health states included remission, treatment response, active UC, and colectomy. The transition probabilities for the induction and maintenance phase were obtained from a network meta-analysis, and effectiveness was measured using quality-adjusted life-years (QALYs). Unit costs were derived from official national sources. Results For first line, the incremental cost-effectiveness ratio (ICER) per QALY was $883 for tofacitinib and $3619 for infliximab, compared with adalimumab. Sensitivity analysis showed that tofacitinib is cost effective in 45% of the iterations, adalimumab in 5%, and infliximab in 50%. Meanwhile, the ICER of adalimumab was $14,927 compared with tofacitinib in second-line treatment. In the sensitivity analysis, tofacitinib was cost effective in 64% of the iterations, followed by adalimumab in 36%. Infliximab and golimumab were not included due to data limitations in the network meta-analysis of second-line treatment. Conclusion The analysis suggests that in Colombia, treatment with tofacitinib for patients with moderate-to-severe UC is a cost-effective option in both lines compared with other treatment options. Supplementary Information The online version contains supplementary material available at 10.1007/s41669-022-00360-4.

Calidad de vida relacionada con la salud por IBDQ-32 en pacientes colombianos con enfermedad inflamatoria intestinal en remisión: Un estudio de corte transversal

“…Colombia es un país que cuenta con estabilidad democrática, con estrechos lazos con Estados Unidos y que ha adoptado prácticas socioculturales norteamericanas con rapidez en las últimas décadas, que incluyen el rápido aumento en la urbanización, el incremento de la obesidad y el mayor consumo de comidas rápidas (11) . Se encuentra catalogada como un país con prevalencia intermedia de EII y con una creciente carga de la enfermedad (11,12) , y su sistema de salud está limitado por barreras socioeconómicas, sociales y geográficas (13) . A pesar del auge del conocimiento acerca las características clínicas y terapéuticas de los pacientes con EII, hay escasez en información acerca del impacto de la enfermedad en la percepción de la vida de los pacientes, especialmente en su bienestar emocional y social, se desconoce qué otras necesidades existen además de lograr control de la enfermedad, y no hay trabajos que evalúen la calidad de vida relacionada con la salud en EII.…”