Premium
A model of the long‐term cost effectiveness of scheduled maintenance treatment with infliximab for moderate‐to‐severe ulcerative colitis
Author(s) -
TSAI H. H.,
PUNEKAR Y. S.,
MORRIS J.,
FORTUN P.
Publication year - 2008
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.2008.03839.x
Subject(s) - medicine , infliximab , ulcerative colitis , cohort , quality of life (healthcare) , maintenance therapy , surgery , chemotherapy , disease , nursing
Summary Background Infliximab (IFX) has been shown to be efficacious in moderate‐severe ulcerative colitis (UC). Aim To evaluate the cost‐effectiveness of a scheduled maintenance treatment (SMT) with IFX in moderate‐severe UC patients. Methods A Markov model was constructed to simulate the progression of a cohort of moderate‐severe UC patients treated with IFX (5 mg/kg) SMT. Transitions were estimated from two phase III trials of IFX (ACT I and ACT II). Standard care, comprising immunomodulators and/or corticosteroids was used as a comparator. Two separate treatment strategies were evaluated – continued treatment in IFX responders and continued treatment in IFX patients achieving remission. The dose of IFX was estimated for a 73 kg typical UC patient in the UK. The results were calculated over 10 years using a discount rate of 3.5% for costs and outcomes. The outcome measure was quality‐adjusted life years (QALYs) estimated using EQ‐5D. Sensitivity analyses explored the uncertainty around the results. Results The incremental cost effectiveness ratio (ICER) for IFX was £27 424 in the responder strategy and £19 696 in the remission strategy at 10 years. In sensitivity analysis, the ICER for IFX in the responder strategy ranged from £21 066 to £86 322 and in the remission strategy ranged from £14 728 to £46 765. The model time horizon and patient body weight were important factors affecting results. Conclusion Eight‐week SMT with IFX appears to be a cost‐effective treatment option for adult patients suffering from moderate to severe UC.