Table 3. Cost-effectiveness of biologics for the treatment of ulcerative colitis (UC).
| Study | Intervention (Biologic treatment) | Comparison treatment | ICER a € d /QALY (including only direct b costs) | ICER a € d /QALY (including both direct b and indirect c costs) | Results of deterministic sensitivity analysis (€ d /QALY) | Source of research funding, Conflict of interest of authors |
|---|---|---|---|---|---|---|
| Cost-effectiveness of biologics in UC patients with earlier conventional medical treatment | ||||||
| Assasi et al. 2009 [22] | IFX followed by IFX dose escalation when relapse | Conventional medical treatment | 407,499 | - | 294,007–629,598 | Canadian federal, provincial, and territorial governments |
| IFX followed by switching to ADA when relapse | Conventional medical treatment | 253,537 | - | 191,701–373,298 | Canadian federal, provincial, and territorial governments | |
| IFX followed by IFX dose escalation when relapse | IFX followed by switching to ADA when relapse | Dominance by comparison treatment | - | - | Canadian federal, provincial, and territorial governments | |
| Bryan et al. 2008 [37] | IFX | CYC | 33,486 | - | 2,399–108,262 | NICE (UK) |
| IFX | Placebo | 20,829 | 7,745–24,268 | NICE (UK) | ||
| IFX | Surgery | 24,293 | - | 2,470–109,612 | NICE (UK) | |
| Chaudhary et al. 2013 [36] | IFX | IV CYC | 26,479 | - | 17,609–38,985 | Merck & Co |
| IFX | Surgery | 15,967 | - | 11,614–24,475 | Merck & Co | |
| Hyde et al. 2007 [38] | IFX | Conventional treatment | 72,711 | - | 29,363–101,989 | NICE (UK) |
| Punekar et al. 2010 [35] | IFX | IV CST | 19,198 | - | Dominance by intervention treatment–94,322 | Schering-Plough Ltd |
| IFX | CYC+IV CST | 30,871 | - | Dominance by intervention treatment–108,272 | Schering-Plough Ltd | |
| IFX | Surgery | 22,161 | - | Dominance by intervention treatment–109,279 | Schering-Plough Ltd | |
| Tsai et al. 2008 [53] | IFX maintenance treatment | Conventional medical treatment | 46,041 (responders only); 33,067 (remission only) | - | 353,367–144,921 (responders only); 24,726–78,511 (remission only) | Schering-Plough Ltd |
| Ung et al. 2014 [54] | IFX | Conventional medical treatment | Source of effectiveness based on RCTs: 115,639 (TTO); 99,663 (VAS), Source of effectiveness based on real-life studies: 66,949 (TTO); 60,101 (VAS) | - | Source of effectiveness based on RCTs: 54,777–248,016, Source of effectiveness based on real-life studies: 31,192–94,337 | CEGIIR and the Alberta Innovates—Health Solutions supported Alberta IBD Consortium |
| Xie et al. 2009 [55] | IFX dose escalating when relapse | Conventional medical treatment | 407,499 | - | 303,515–629,598 | Not stated, Conflict of interest: Eli Lilly Canada Inc, GlaxoSmithKline Inc, Abbott Laboratories Ltd, Janssen-Ortho Inc., Hoffman-La Roche Ltd |
| IFX switching to ADA when relapse | Conventional medical treatment | 253,537 | - | 193,349–373,298 | Not stated, Conflict of interest: Eli Lilly Canada Inc, GlaxoSmithKline Inc, Abbott Laboratories Ltd, Janssen-Ortho Inc., Hoffman-La Roche Ltd | |
ADA, Adalimumab; CEGIIR, Centre of Excellence for Gastrointestinal Inflammation and Immunity Research; CST, Corticosteroid; CYC, Cyclosporine; IFX, Infliximab; IV, Intravenous; NICE, National Institute for Health and Care Excellence; RCT, Randomized controlled trial; QALY, Quality-Adjusted Life Year; TTO, Time Trade-off; VAS, Visual analog scale.
aThe difference in costs divided by the difference in health effects.
bThe resources consumed.
cProductivity costs for the patient and family members.
dAll costs converted into 2014 euro.