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Cost-effectiveness analysis of infliximab, adalimumab, golimumab, vedolizumab and tofacitinib for moderate to severe ulcerative colitis in Spain
  1. Cristina Trigo-Vicente1,
  2. Vicente Gimeno-Ballester2,
  3. Alejandro López-Del Val3
  1. 1 Pharmacy, C.R.P. Nuestra Señora del Pilar, Zaragoza, Spain
  2. 2 Department of Pharmacy, Miguel Servet University Hospital, Zaragoza, Spain
  3. 3 Dean of Health Science Faculty, Universidad San Jorge, Villanueva de Gallego, Spain
  1. Correspondence to Ms Cristina Trigo-Vicente, Pharmacy, C.R.P. Nuestra Señora del Pilar, Zaragoza 50009, Spain; cristinatrigo86{at}gmail.com

Abstract

Objective Despite the biological drugs, the treatment of moderate to severe ulcerative colitis is still a challenge, particularly in resource-limited settings. The aim of this study was to assess the efficiency of biological drugs and tofacitinib for moderate to severe ulcerative colitis in the Spanish context.

Methods A Markov model was built to simulate the progression of moderate to severe ulcerative colitis in a cohort of patients. The model used a time horizon of 10 years. The perspective chosen was the National Health Service, with a discount rate of 3%, and a threshold of €30,000/quality adjusted life-year (QALY). It carried out a one-way sensitivity analysis and probabilistic sensitivity analysis.

Results The comparison of infliximab with adalimumab and golimumab estimated an incremental cost-effectiveness ratio (ICER) of €43,928.07/QALY and €31,340.69/QALY, with a difference of − 0.43 and − 0.82 QALY, respectively. Vedolizumab vs infliximab achieved an ICER of €122,890.19/QALY with a gain of 0.46 QALY. The comparison of infliximab with tofacitinib yielded an estimated ICER of €270,503.19/QALY, with a slight gain in QALY (0.16). The one-way sensitivity analysis showed a robust study.

Conclusion For a threshold of €30,000/QALY, adalimumab was the most cost-effective treatment versus infliximab for moderate to severe ulcerative colitis in Spain.

  • ulcerative colitis, markov model, cost-effectiveness analysis, biological drugs, tofacitinib

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