Economic Evaluation of Sarilumab in the Treatment of Adult Patients with Moderately-to-Severely Active Rheumatoid Arthritis Who Have an Inadequate Response to Conventional Synthetic Disease-Modifying Antirheumatic Drugs

Muszbek, N.; Proudfoot, Clare; Fournier, Marie; Chen, Chieh I.; Kuznik, Andreas; Kiss, Zsófia; Gál, Péter; Michaud, Kaleb

doi:10.1007/s12325-019-00946-1

Cited by 12 publications

(23 citation statements)

References 37 publications

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“…Of the 31 models included in this review, 25 studies were published in peer-reviewed journals 5,[14][15][16][17][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] , five of them were NICE technology appraisals [11][12][13]40,41 , and two models were identified from the gray literature. 42,43 Table 1 provides an overview of each profiled publication.…”

Section: Overviewmentioning

confidence: 99%

“…With regard to geography, the majority of models were conducted from the US or UK perspectives, including nine UK models 5,[11][12][13][22][23][24]40,41 (includes five NICE HTAs [11][12][13]40,41 ) and nine US models. 14,15,[25][26][27][28][29]42,43 Of the US models, five of them were sponsored by pharmaceutical companies, two of them by academic consortia, and one each was sponsored by an HTA body or an analytics company. Among the other countries, Greece, 16,30 and South Korea 31,32 had two models each, while Colombia, 33 Germany 34 , Iran, 35 Italy, 36 the Netherlands, 37 Norway, 38 Serbia, 39 Spain, 17 and Taiwan 44 had one model each.…”

Section: Overviewmentioning

confidence: 99%

“…All models focused on evaluating the CU of one or more new or previously-introduced interventions, with four models of tocilizumab, 22,29,34,38 four of tofacitinib, 13,14,16,17 three each of sarilumab, 12,15,26 and certolizumab, 30,39,41 two of adalimumab 5,33 and etanercept, 27,31 and one each of abatacept, 41 baricitinib, 11 and rituximab. 35 Six studies evaluated specific sequences of TIMs, 23,27,28,36,41,43 while four studies each evaluated multiple drugs within a class.…”

Section: Overviewmentioning

confidence: 99%

“…Framework selection is therefore a key factor in estimating the effectiveness of a given treatment over time. Of the 31 models included in this systematic review, 20 (65%) included a patient-level simulation component, with 11 (35%) structured with a single structure 5,14,17,22,25,29,[34][35][36]41,43 and 9 (23%) structured as two-stage simulation models. [11][12][13]15,23,24,26,27,40 The remaining 11 (35%) models were set up as Markov cohort models.…”

Section: Model Structure: Simulation Typementioning

confidence: 99%

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Cost-utility analyses of targeted immunomodulators in rheumatoid arthritis: systematic review

Sussman¹,

Tao²,

Patel

et al. 2020

Journal of Medical Economics

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Aims: Cost-utility (CU) modeling is a common technique used to determine whether new treatments represent good value for money. As with any modeling exercise, findings are a direct result of methodology choices, which may vary widely. Several targeted immuno-modulators have been launched in recent years to treat moderate-to-severe rheumatoid arthritis (RA) which have been evaluated using CU methods. Our objectives were to identify common and innovative modeling choices in moderateto-severe RA and to highlight their implications for future models in RA. Materials and methods: A systematic literature search was conducted to identify CU models in moderate-to-severe RA published from January 2013 to June 2019. Studies must have included an active comparator and used quality-adjusted life-years (QALYs) as the common measure of effectiveness. Modeling methods were characterized by stakeholder perspective, simulation type, mapping between parameters, and data sources.Results: Thirty-one published modeling studies were reviewed spanning 13 countries and 9 drugs, with common methodological choices and innovations observed among them. Over the evaluated time period, we observed common methods and assumptions that are becoming more prominent in the RA CU modeling landscape, including patient-level simulations, two-stage models combining trial results and real-world evidence, real-world treatment durations, long-term health consequences, and Health Assessment Questionnaire (HAQ)-related hospitalization costs. Models that consider the societal perspective are increasingly being developed as well. Limitations: This review did not consider studies that did not report QALYs as a utility measure, models published only as conference abstracts, or cost-consequence models that did not report an incremental CU ratio. Conclusions: CU modeling for RA increasingly reflects real-world conditions and patient experiences which are anticipated to provide better information in the assessment of health technologies. Future CU models in RA should consider applying the observed advances in modeling choices to optimize their CU predictions and simulation of real-world outcomes.

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Section: Overviewmentioning

confidence: 99%

Section: Overviewmentioning

confidence: 99%

Section: Overviewmentioning

confidence: 99%

Section: Model Structure: Simulation Typementioning

confidence: 99%

See 2 more Smart Citations

Cost-utility analyses of targeted immunomodulators in rheumatoid arthritis: systematic review

Sussman¹,

Tao²,

Patel

et al. 2020

Journal of Medical Economics

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“…Several randomized controlled trials (RCTs) have demonstrated a higher efficacy of tofacitinib [2][3][4] and bDMARDs [5][6][7][8] compared with csDMARDs in patients with moderate to severe RA. However, in real-world clinical practice, patients continue to use csDMARDs for various reasons, including safety concerns, cost considerations, and patient preference [9,10].…”

Section: Introductionmentioning

confidence: 99%

Comparative Cost-Effectiveness of Tofacitinib With Continuing Conventional Synthetic Disease-Modifying Anti-Rheumatic Drugs for Active Rheumatoid Arthritis in South Korea

Shim

Lee

et al. 2021

Rheumatol Ther

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Introduction:The objective of this study was to evaluate the cost-effectiveness of initiating treatment with tofacitinib and subsequently incorporating it into a conventional synthetic disease-modifying anti-rheumatic drug (csDMARD) treatment sequence and to compare the cost-effectiveness of this sequence with that of continuing csDMARDs alone in patients with active rheumatoid arthritis (RA). Methods: A cohort-based Markov model was used to evaluate the cost-effectiveness of two tofacitinib treatment sequences compared with that of continuing the csDMARD treatment sequence over a lifetime. Of the two tofacitinib sequences, the first consisted of initial tofacitinib treatment followed by biologic DMARDs (bDMARDs) and the second consisted of csDMARD treatments followed by tofacitinib. A third treatment sequence, continuing the csDMARD treatment sequence before starting bDMARDs, was used as a comparator. Efficacy was assessed using the American College of Rheumatology (ACR) response rates (ACR 20, ACR 50, and ACR 70) after 6 months, which were converted to changes in the health assessment questionnaire-disability index (HAQ-DI) score. Utility was estimated by mapping from the HAQ-DI score, costs were analyzed from a Korean societal perspective, and outcomes were considered in terms of qualityadjusted life-years (QALYs). One-way sensitivity analysis and probabilistic sensitivity analysis were performed to assess the robustness of the model. Results: The incremental cost-effectiveness ratios over a lifetime for starting with tofacitinib and incorporating tofacitinib into the csDMARD treatment sequence versus continuing csDMARDs only were US$14,537 per QALY and US$7,086 per QALY, respectively. One-way sensitivity analysis and probabilistic sensitivity analysis confirmed the robustness of these results. Conclusion: Starting with tofacitinib and incorporating it into a csDMARDs treatment sequence is cost-effective compared to continuing csDMARDs alone in patients with RA.

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Sarilumab cost effective in RA not responding to traditional DMARDs

2019

PharmacoEcon Outcomes News

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Economic Evaluation of Sarilumab in the Treatment of Adult Patients with Moderately-to-Severely Active Rheumatoid Arthritis Who Have an Inadequate Response to Conventional Synthetic Disease-Modifying Antirheumatic Drugs

Cited by 12 publications

References 37 publications

Cost-utility analyses of targeted immunomodulators in rheumatoid arthritis: systematic review

Cost-utility analyses of targeted immunomodulators in rheumatoid arthritis: systematic review

Comparative Cost-Effectiveness of Tofacitinib With Continuing Conventional Synthetic Disease-Modifying Anti-Rheumatic Drugs for Active Rheumatoid Arthritis in South Korea

Sarilumab cost effective in RA not responding to traditional DMARDs

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