Economic Evaluation of Tocilizumab Monotherapy Compared to Adalimumab Monotherapy in the Treatment of Severe Active Rheumatoid Arthritis

Carlson, Josh J.; Ogale, Sarika; Dejonckheere, F.; Sullivan, Sean D.

doi:10.1016/j.jval.2014.10.013

Cited by 29 publications

(43 citation statements)

References 27 publications

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“…Nonetheless, TCZ's favorable cost-effectiveness (from €13,220/QALY to €36,900/QALY) as a monotherapy Fig. 2 Cost-effectiveness scatterplot was demonstrated by findings of economic evaluations performed in the USA [40], Turkey [41], Spain [42], Portugal [43], Scotland [44], UK [45] and Romania [46]. A UK-based study [47], using a similar research design and model, reports an ICER of £7,289/QALY for TCZ first line and an ICER of £11,400/QALY for TCZ second line, leading to the notion that the current study's findings could be regarded rather conservative.…”

Section: Discussionmentioning

confidence: 99%

Cost-utility analysis of tocilizumab monotherapy in first line versus standard of care for the treatment of rheumatoid arthritis in Greece

et al. 2015

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The study aims to evaluate the cost-effectiveness of adding tocilizumab (TCZ) first line to a treatment sequence for patients with active rheumatoid arthritis (RA), who had an inadequate response to one or more traditional synthetic disease-modifying antirheumatic drugs (DMARDs) and are intolerant to methotrexate (MTX), or in whom continued treatment with MTX is considered inappropriate. An individual simulation model was applied to project lifetime costs and outcomes for 10,000 patients from a payer's perspective. The analysis compared the standard treatment pathway (STP) with a similar pathway, where treatment was initiated with TCZ. QALYs were used as primary efficacy outcomes. Efficacy data were obtained from the ADACTA trial and a network meta-analysis. Clinical practice standards were derived from an expert panel of Greek rheumatologists. Results indicate that a treatment sequence starting with TCZ yields 1.17 more QALYs (9.38 vs. 8.21) at an additional cost of €3,744 (€119,840 vs. €86,096) compared with the STP. The incremental cost-effectiveness ratio was €28,837/QALY gained. Probabilistic sensitivity analysis confirms robustness of these findings as consistently below a threshold of €45,000. The results of the analysis suggest that TCZ, when used as a first-line biologic monotherapy, can be a cost-effective treatment option for the management of active RA in patients in need of biologic monotherapy.

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Section: Discussionmentioning

confidence: 99%

Cost-utility analysis of tocilizumab monotherapy in first line versus standard of care for the treatment of rheumatoid arthritis in Greece

et al. 2015

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“…52 In an analysis of data from 45000 patients with RA from the Optum Research Database, ETN was the most effective and had the lowest biologic cost per effectively treated patient with RA, compared with ADA, IFX, abatacept, and golimumab. 53 Some studies have suggested that TCZ may be more cost-effective than ADA monotherapy 54 and ADA or ETN when used in combination with methotrexate. 55 Cumulative medical costs of TCZ were similar to those of ADA but were greater than those of ETN in our study; however, further research is needed to determine the cost-effectiveness of the TCZ therapeutic strategy in this population.…”

Section: Discussionmentioning

confidence: 99%

Treatment Patterns, Direct Cost of Biologics, and Direct Medical Costs for Rheumatoid Arthritis Patients: A Real-world Analysis of Nationwide Japanese Claims Data

Sugiyama

Kawahito

Fujii

et al. 2016

Clinical Therapeutics

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“…The mortality risk adjustment is a function of HAQ score . Researchers have used this in previous RA models . RA's specific mortality was calculated based on the life table for the total population in the United States retrieved from the CDC .…”

Section: Methodsmentioning

confidence: 99%

“…[18] Researchers have used this in previous RA models. [19] RA's specific mortality was calculated based on the life table for the total population in the United States retrieved from the CDC. [20] Using the NDB, the mean HAQ score was calculated for each of the four disease states in the model and applied in the following equation:…”

Section: Mortality Ratementioning

confidence: 99%

Modelling the cost-effectiveness of statin therapy in rheumatoid arthritis: a Markov-cycle evaluation from national data bank for rheumatic diseases

Almasri

Lai

Noor

et al. 2017

J Pharm Health Serv Res

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Objectives Rheumatoid arthritis (RA) affects approximately 1% of the world's population. In the United States, an estimated 1.5 million adults live with RA. Due to the high prevalence of comorbidities among patients with RA, the economic burden of the disease has raised concerns over the past decades. Researchers have increasingly recognized that the treatment strategy should focus on both disease progression and comorbidities management. The study aimed to evaluate the potential long‐term benefits of adjunctive statin therapy in combination with one or more biologic disease‐modifying antirheumatic drugs (DMARDs), versus biologic DMARDs alone, in patients with RA using a decision analytical framework and determined the associated incremental cost‐effectiveness ratios. Methods This study was conducted to determine the cost‐effectiveness of using adjunctive statin therapy in combination with one or more biologic DMARD, versus biologic DMARDs alone, in patients with RA. The study first conducted a secondary data analysis using the National Data Bank between 2003 and 2013 to identify study subjects and parameters used for further decision analysis. Second, a Markov simulation model was developed to assess the long‐term cost‐effectiveness of adjunctive statin therapy. Key findings The findings indicate that the clinical benefits of adjunctive statin therapy in treating RA disease progression resulted in an incremental cost per QALY gain, $36 642/QALY over 10 years, compared to biologic DMARDs alone. Conclusions Given the high costs associated with the management of RA, our study successfully developed a Markov decision model to simulate real‐world treatment processes and provide a fundamental framework for further investigating cost‐effeteness of statin therapy in RA. More importantly, it provides decision‐makers with scientific evidence of clinical and economic evaluation for optimal therapeutic outcomes.

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Economic Evaluation of Tocilizumab Monotherapy Compared to Adalimumab Monotherapy in the Treatment of Severe Active Rheumatoid Arthritis

Abstract: TCZ Mono is projected to be cost-effective compared with ADA Mono in patients with severe rheumatoid arthritis for whom methotrexate is not appropriate, from a US payer perspective.

Cited by 29 publications

References 27 publications

Cost-utility analysis of tocilizumab monotherapy in first line versus standard of care for the treatment of rheumatoid arthritis in Greece

Cost-utility analysis of tocilizumab monotherapy in first line versus standard of care for the treatment of rheumatoid arthritis in Greece

Treatment Patterns, Direct Cost of Biologics, and Direct Medical Costs for Rheumatoid Arthritis Patients: A Real-world Analysis of Nationwide Japanese Claims Data

Modelling the cost-effectiveness of statin therapy in rheumatoid arthritis: a Markov-cycle evaluation from national data bank for rheumatic diseases

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