The cost-effectiveness of biologic versus non-biologic treatments and the health-related quality of life among a sample of patients with inflammatory bowel disease in a tertiary care center in Saudi Arabia

AlRuthia, Yazed; Almadi, Majid A; Aljebreen, Abdulrahman; Azzam, Nahla; Alrasheed, Hala; Almuaythir, Ghadah S.; Saeed, Maria; HajkhderMullaissa, Baraa; Alharbi, Othman

doi:10.1080/13696998.2020.1791889

Cited by 6 publications

(7 citation statements)

References 47 publications

(61 reference statements)

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“…A study of the literature revealed that prior trials evaluating the efficacy of ADA and IFX in Crohn's patients mainly assessed the medications' clinical efficacy ( 33 – 38 ). Other studies have investigated the efficacy of biological medications to non-biologic drugs in people with Crohn's disease or IBD ( 39 , 40 ).…”

Section: Discussionmentioning

confidence: 99%

Factors associated with health-related quality of life in patients with Crohn's disease in Iran: A prospective observational study

et al. 2023

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This was a 1-year prospective observational study of the health-related quality of life (HRQoL) of moderate to severe crohn's disease (CD) patients in Iran. Patients' HRQoL were measured using the EQ-5D 3L, EQ-VAS, and IBDQ-9 tools. HRQoL among CD patients were compared using the T-test, Mann–Whitney, Chi-square, and Fisher's exact tests. To discover factors influencing patients' HRQoL, multivariate linear regression and multivariate logistic regression tests were utilized. The study included 222 CD patients, with a mean age of 34.67 and mean disease duration of 7.32 years. The dimensions with the worst reported “relatively or extreme problems” were P/D: 77.5% and A/D: 63.1%. Employment, having “other chronic diseases,” and ADA consumption were the most important independent predictors of HRQoL in CD patients, [β = 0.21 (EQ-5D index), β = 19.61 (EQ-VAS), β = 12.26 (IBDQ-9), OR: 0.09 (MO), OR: 0.12 (UA), OR: 0.21 (P/D), OR: 0.22 (A/D)], [β = −0.15 (EQ-5D index), β = −5.84 (IBDQ-9), β = −11.06 (EQ-VAS), OR: 4.20 (MO), OR: 6.50 (UA)], and [OR: 2.29 (A/D)], respectively. Unemployment, presence of “other chronic conditions” had the greatest negative impact on HRQoL of CD patients. There were significant differences in the probability of reporting “relatively or extreme problems” in the SC and A/D dimensions between patients using adalimumab (ADA) and infliximab (IFX).

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Section: Discussionmentioning

confidence: 99%

Factors associated with health-related quality of life in patients with Crohn's disease in Iran: A prospective observational study

et al. 2023

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“…Almaslami et al 25 AlRuthia et al 26 Almalki et al 27 Al-Senani et al 28 Hersi et al 29 Knott et al 30 Cara et al 31 Alsaqa'aby et al 32 Al-Aidaroos et al 33 Gupta et al 34 Joosub et al 35 Nasef et al 36 25 AlRuthia et al 26 Almalki et al 27 Al-Senani et al 28 Hersi et al 29 Knott et al 30 Cara et al 31 Alsaqa'aby et al 32 Al-Aidaroos et al 33 Gupta et al 34 Joosub et al 35 Nasef et al 36…”

Section: Studymentioning

confidence: 99%

“…Almaslami et al 25 AlRuthia et al 26 Almalki et al 27 Al-Senani et al 28 Hersi et al 29 Knott et al 30 Cara et al 30 Alsaqa'aby et al 32 Al-Aidaroos et al 33 Gupta et al 34 Joosub et al 35 Nasef et al 36 the definition and criteria for choosing the comparator are not clearly stated within the analyses. Estimating costs should include payers' and societal perspectives in the reference case, as described in the second panel.…”

Section: Table 3 Limitation Domain Summary Details Amentioning

confidence: 99%

Methodological Approaches to Cost-Effectiveness Analysis in Saudi Arabia: What Can We Learn? A Systematic Review

Maraiki

Bazarbashi

Scuffham

et al. 2022

MDM Policy & Practice

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Objective The recent establishment of the health technology assessment (HTA) entity in the Kingdom of Saudi Arabia (KSA) has resulted in increased interest in economic evaluation. The aim of this study is to evaluate the technical approaches used in published economic evaluations and the limitations reported by the authors of the respective studies that could affect the ability to perform economic evaluations in the KSA. Methods We conducted a systematic literature review of published economic evaluations performed for the KSA over the past 10 years. An electronic literature search of the PubMed, EMBASE, and Cochrane databases was performed. A CHEERS checklist was used to assess the quality of reporting. Reported limitations were classified into domains including the definition of perspectives, identification of comparators, estimation of costs and resources, and use of the incremental cost-effectiveness ratio threshold. Results Twelve evaluations were identified; most involved cost-effectiveness analysis (92%). Missing and unclear data were found within the CHEERS criteria. Regardless of the perspective used, most described the perspective as an “institutional” perspective (70%) and almost half were reclassified by the current reviewer (42%). Most did not clearly state the comparator (83%), and published model comparators were commonly used (50%). Resource estimation was mostly performed by the authors of the respective studies (67%), and costs were mostly obtained from hospital institutional data (75%). The lack of an established threshold for the country-specific willingness to pay was observed in 50% of the analyses. Conclusions Economic evaluations from the KSA are limited. Capacity building and country-specific HTA guidelines could improve the quality of evaluations to better inform decision making. Highlights Economic analysis of health technology should follow standard guidelines. Unfortunately, these guides are often underutilized, and our findings identify considerable missing, not clearly stated, or incomplete data within the analyses, which can weaken the impact of the recommendations. The limitations reported by the authors of the respective studies emphasize the suboptimal quality of the reporting. A lack of data was frequently identified and resulted in using “institutional” practice as a major source of data input for the analyses. In light of the call for the establishment of an HTA entity in the KSA, framing a standard analytic approach when conducting economic evaluations will support HTA in informing resource allocation decisions. We hope that our findings highlight the need for country-specific guidance to improve practice and enhance future research.

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“…In contrast, the concomitant use of anti-TNF biologics (INF or ADA) with an immunomodulator, such as azathioprine, and proactive therapeutic drug monitoring are associated with lower risk of treatment failure with anti-TNF therapy [ 28 , 29 ]. In Saudi Arabia, the utilization of biologics in general, and anti-TNF, in particular, is believed to be as high as 60% among CD patients [ 30 , 31 ]. However, no study has, so far, compared the rates of treatment failure among IBD patients treated with INF or ADA, which are the most-commonly utilized biologics in Saudi Arabia for IBD treatment [ 31 ].…”

Section: Introductionmentioning

confidence: 99%

“…In Saudi Arabia, the utilization of biologics in general, and anti-TNF, in particular, is believed to be as high as 60% among CD patients [ 30 , 31 ]. However, no study has, so far, compared the rates of treatment failure among IBD patients treated with INF or ADA, which are the most-commonly utilized biologics in Saudi Arabia for IBD treatment [ 31 ]. Therefore, the aims of this study were to compare the rates and predictors of treatment failure among IBD patients on anti-TNF biologics in Saudi Arabia, as demonstrated by the presence of deep ulcers and a simple endoscopic score (SES–CD) of one or more for CD, and a Mayo score of two or more for UC patients [ 32 , 33 ].…”

Section: Introductionmentioning

confidence: 99%

Predictors of Anti-TNF Therapy Failure among Inflammatory Bowel Disease (IBD) Patients in Saudi Arabia: A Single-Center Study

Alharbi

Aljebreen

Azzam

et al. 2022

JCM

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Background: The advent of monoclonal antibodies (mAbs) has revolutionized the management of many immune-mediated diseases such as inflammatory bowel disease (IBD). Infliximab and adalimumab were the first mAbs approved for the management of IBD, and are still commonly prescribed for the treatment of both Crohn’s disease (CD) and ulcerative colitis (UC). Although mAbs have demonstrated high effectiveness rates in the management of IBD, some patients fail to respond adequately to mAbs, resulting in disease progression and the flare-up of symptoms. Objective: The objective was to explore the predictors of treatment failure among IBD patients on infliximab (INF) and adalimumab (ADA)—as demonstrated via colonoscopy with a simple endoscopic score (SES–CD) of ≥1 for CD and a Mayo score of ≥2 for UC—and compare the rates of treatment failure among patients on those two mAbs. Methods: This was a prospective cohort study among IBD patients aged 18 years and above who had not had any exposure to mAbs before. Those patients were followed after the initiation of biologic treatment with either INF or ADA until they were switched to another treatment due to failure of these mAbs in preventing the disease progression. Univariate and multiple logistic regressions were conducted to examine the predictors and rates of treatment failure. Results: A total of 146 IBD patients (118 patients on INF and 28 on ADA) met the inclusion criteria and were included in the analysis. The mean age of the patients was 31 years, and most of them were males (59%) with CD (75%). About 27% and 26% of the patients had penetrating and non-stricturing–non-penetrating CD behavior, respectively. Patients with UC had significantly higher odds of treatment failure compared to their counterparts with CD (OR = 2.58, 95% CI [1.06–6.26], p = 0.035). Those with left-sided disease had significantly higher odds of treatment failure (OR = 4.28, 95% CI [1.42–12.81], p = 0.0094). Patients on ADA had higher odds of treatment failure in comparison to those on INF (OR = 26.91, 95% CI [7.75–93.39], p = 0.0001). Conclusion: Infliximab was shown to be more effective in the management of IBD, with lower incidence rates of treatment failure in comparison to adalimumab.

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The cost-effectiveness of biologic versus non-biologic treatments and the health-related quality of life among a sample of patients with inflammatory bowel disease in a tertiary care center in Saudi Arabia

Abstract: The cost-effectiveness of biologic versus non-biologic treatments and the health-related quality of life among a sample of patients with inflammatory bowel disease in a tertiary care center in

Cited by 6 publications

References 47 publications

Factors associated with health-related quality of life in patients with Crohn's disease in Iran: A prospective observational study

Factors associated with health-related quality of life in patients with Crohn's disease in Iran: A prospective observational study

Methodological Approaches to Cost-Effectiveness Analysis in Saudi Arabia: What Can We Learn? A Systematic Review

Predictors of Anti-TNF Therapy Failure among Inflammatory Bowel Disease (IBD) Patients in Saudi Arabia: A Single-Center Study

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