Table 2.
Summary of economic evaluations in the treatment of CD.
| Study, year of publication | Study treatment | Comparators | CE ratio (Cost/QALY) (Currency year) |
CE ratio ($/QALY) (CAD 2016) |
|---|---|---|---|---|
| IFX | ||||
|
| ||||
| Ananthakrishnan et al., 2011 [19] | IFX (tailored) | Antibiotics | Dominated | Dominated |
| IFX (upfront) | Antibiotics | $2,757,857/QALY (USD 2010) |
$3,121,546/QALY | |
|
| ||||
| Ananthakrishnan et al., 2013 [20] | IFX (MTN or dose escalation) | IFX (dose escalation) | $49,278/QALY (USD 2010) |
$55,776/QALY |
|
| ||||
| Blackhouse et al., 2012 [21] | IFX | Std care |
$222,955/QALY (CAD 2011)∗ |
$229,197/QALY |
|
| ||||
| Bodger et al., 2009 [22] | IFX (1 year tx) | Std care | £19,050/QALY (GBP 2006) |
$49,290/QALY |
| IFX (2 year tx) | Std care | £21,300/QALY (GBP 2006) |
$55,112/QALY | |
|
| ||||
| Doherty et al., 2012 [23] | IFX | AZA/6MP | $1,831,912/QALY (USD 2010) |
$2,073,493/QALY |
|
| ||||
| Dretzke et al., 2011 [24] | IFX IND (severe disease) | Std care | Dominant | Dominant |
| IFX MTN (severe disease) | Std care | £68,315/QALY (GBP 2011)∗ |
$157,706/QALY | |
| IFX MTN (severe disease) | IFX IND (severe disease) | £5,030,000/QALY (GBP 2011)∗ |
$11,611,849/QALY | |
| IFX IND (moderate disease) | Std care | £94,321/QALY (GBP 2011)∗ |
$217,741/QALY | |
| IFX MTN (moderate disease) | Std care | £317,991/QALY (GBP 2011)∗ |
$734,088/QALY | |
| IFX MTN (moderate disease) | IFX IND (moderate disease) | £13,900,000/QALY (GBP 2011)∗ |
$32,088,410/QALY | |
|
| ||||
| Jaisson-Hot et al., 2004 [25] | IFX (retreatment with relapse or no response) | Std care (including surgery) | €63,700.82/QALY (EUR 2004) |
$122,252/QALY |
| IFX MTN | Std care (including surgery) | €784,057.49/QALY (EUR 2004) |
$1,504,736/QALY | |
|
| ||||
| Kaplan et al., 2007 [26] | IFX (increasing dose) | ADA | $332,032/QALY (USD 2006) |
$426,928/QALY |
|
| ||||
| Lindsay et al., 2008 [27] | IFX (luminal CD) | Std care | £26,128/QALY (GBP 2006) |
$60,316/QALY |
| IFX (fistulizing CD) | Std care | £29,752/QALY (GBP 2006) |
$68,683/QALY | |
|
| ||||
| Punekar et al., 2010 [28] | IFX | Std care | £14,607/QALY (GBP 2006) |
$37,794/QALY |
|
| ||||
| Steenholdt et al., 2014 [29] | Individualised therapy (serum IFX and IFX antibody levels using the proposed algorithm) | IFX dose intensification | Dominant | Dominant |
|
| ||||
| Steenholdt et al., 2015 [30] | Individualised therapy (serum IFX and IFX antibody levels using the proposed algorithm) | IFX dose intensification | Dominant | Dominant |
|
| ||||
| Tang et al., 2012 [31] | IFX | ADA | Dominant | Dominant |
| IFX | Certolizumab Pegol | Dominant | Dominant | |
| IFX | NAT | Dominant | Dominant | |
|
| ||||
| Velayos et al., 2013 [32] | Testing-based strategy (IFX) | Dose escalation | Dominant | Dominant |
|
| ||||
| ADA | ||||
|
| ||||
| Blackhouse et al., 2012 [21] | ADA | Std care |
$193,305/QALY (CAD2011)∗ |
$198,717/QALY |
| ADA | IFX |
$451,165/QALY (CAD 2011)∗ |
$463,797/QALY | |
|
| ||||
| Bodger et al., 2009 [22] | ADA (1 year tx) | Std care | £7,190/QALY (GBP 2006) |
$18,603/QALY |
| ADA (2 year tx) | Std care | £10,310/QALY (GBP 2006) |
$26,676/QALY | |
|
| ||||
| CADTH, 2008 [33] | ADA | Std care |
$113,034/QALY (CAD 2008)∗ |
$128,067/QALY |
| ADA | IFX | Dominant | Dominant | |
|
| ||||
| Dretzke et al., 2011 [24] | ADA IND (severe disease) | Std care | Dominant | Dominant |
| ADA MTN (severe disease) | Std care | £7,749/QALY (GBP 2011)∗ |
$17,888/QALY | |
| ADA MTN (severe disease) | ADA MTN | £4,980,000/QALY (GBP 2011)∗ |
$11,496,423/QALY | |
| ADA IND (moderate disease) | Std care | Dominant | Dominant | |
| ADA MTN (moderate disease) | Std care | £160,079/QALY (GBP 2011)∗ |
$369,545/QALY | |
| ADA MTN (moderate disease) | ADA IND (moderate disease) | £13,900,000/QALY (GBP 2011)∗ |
$32,088,410/QALY | |
|
| ||||
| Loftus Jr et al., 2009 [34] | ADA (severe disease) | Std care | £16,064/QALY (GBP 2006) |
$38,195/QALY |
| ADA (moderate-to-severe disease) | Std care | £33,731/QALY (GBP 2006) |
$80,202/QALY | |
|
| ||||
| Yu et al., 2009 [35] | ADA MTN | IFX MTN | Dominant | Dominant |
|
| ||||
| IFX + AZA | ||||
|
| ||||
| Marchetti et al., 2013 [36] | IFX + AZA (top-down strategy) | Steroid (step-up strategy) | Dominant | Dominant |
|
| ||||
| Saito et al., 2013 [37] | IFX + AZA | IFX | £24,917/QALY (GBP 2004) |
$57,051/QALY |
|
| ||||
|
Other biologics (GOL, NAT, VED) |
||||
|
| ||||
| Ananthakrishnan et al., 2012 [38] | NAT | Certolizumab Pegol | $381,678/QALY (USD 2010) |
$432,011/QALY |
|
| ||||
|
Immunosuppressants (AZA, 6MP, cyclosporine) |
||||
|
| ||||
| Ananthakrishnan et al., 2011 [19] | AZA | Antibiotics | Dominated | Dominated |
|
| ||||
| Doherty et al., 2012 [23] | AZA/6MP | No therapy | $299,188/QALY (USD 2010) |
$338,643/QALY |
|
| ||||
| Priest et al., 2006 [39] | AZA | MTX | Dominant | Dominant |
| AZA | No immunosuppressant therapy | Dominant | Dominant | |
ADA: adalimumab; AZA: azathioprine; CAD: Canadian dollar; CADTH: Canadian Agency for Drugs and Technologies in Health; CE: cost-effectiveness; EUR: Euros; GBP: Great British Pound; GMA: granulocyte-monocyte aphaeresis; GOL: golimumab; IFX: infliximab; IND: induction; MTN: maintenance; NAT: natalizumab; QALY: quality adjusted life years; Std: standard; tx: treatment; US: United States; USD: United States Dollar; VED: vedolizumab; 6MP: 6-mercaptopurine. Studies in italic are Canadian studies. A study may appear in more than one table if different treatments were analyzed. ∗Publishing year.