Table 5.
Cost-effectiveness analyses of biologic agents for UC
| Intervention, comparator, and target population | Country | Time horizon | Study perspective | ICER ($/QALY) | Reference |
|---|---|---|---|---|---|
| IFX, includes first infusion of 5 mg/kg on the 4th day, with concomitant standard care comprising IV therapy for an additional 7 days during the hospital stay versus cyclosporine, includes infusion of 4 mg/kg on the 4th to 11th days, with concomitant standard care comprising IV therapy for an additional 7 days during the hospital stay in acute severe UC patients not responding to 72 hours of IV steroid therapy | UK | 1 year | Health care payer | 41,000 | Punekar et al68 |
| 5 mg/kg and 10 mg/kg IFX + ADA versus usual care in Canadian patients diagnosed with refractory UC | Canada | 5 years | Health care payer | 590,000 | Xie et al69 |
| 5 mg/kg IFX + ADA versus usual care in Canadian patients diagnosed with refractory UC | Canada | 5 years | Health care payer | 370,000 | Xie et al69 |
| IFX treatment 5 mg/kg, remission strategy versus standard care in patients with moderate-to-severe UC in the UK | UK | 10 years | Health care payer | 44,000 | Tsai et al70 |
| IFX treatment 5 mg/kg, responder strategy versus standard care in patients with moderate-to-severe UC in the UK | UK | 10 years | Health care payer | 62,000 | Tsai et al70 |
Notes: Study perspective: The study perspective is the viewpoint from which costs and benefits are calculated. All studies included in our review were conducted from a health care payer perspective and include only direct costs incurred by insurance companies (private or national health care service). Time horizon: The time horizon is the length of time in which resource use (eg, drug use, hospital admissions) are measured. ICER is calculated by dividing the incremental cost by the incremental QALYs gained of an intervention over the examined comparator. An ICER is not calculated when the intervention costs less (cost-saving) and is at least as effective as the comparator. In many of these cases, the intervention is considered “dominant” over the comparator, suggesting that it is both cost-saving and more effective.
Abbreviations: UC, ulcerative colitis; ICER, incremental cost-effectiveness ratio; QALY, quality-adjusted life-year; IFX, infliximab; IV, intravenous; ADA, adalimumab.