. 2023 Feb 24;8(1):23814683231156433. doi: 10.1177/23814683231156433

Table 1.

Description of Studies

	First Author, Country	Study Title
	First Author, Country	Primary Findings, Incremental Cost-Effectiveness Ratio
1	Aliyev et al.,³¹ United States	Cost-effectiveness comparison of ustekinumab, infliximab, or adalimumab for the treatment of moderate-severe Crohn’s disease in biologic-naive patients
1	Aliyev et al.,³¹ United States	IFX dominated ADA and UST; NMB of IFX v. UST = US $29,798 NMB IFX v. ADA = US $9,943
2	Ananthakrishnan et al.,³² United States	Can mucosal healing be a cost-effective endpoint for biologic therapy in Crohn’s disease? A decision analysis
2	Ananthakrishnan et al.,³² United States	ICER of mucosal healing v. clinical response = $47,278/QALY gained
3	Arseneau et al.,³³ United States	Cost-utility of initial medical management for Crohn’s disease perianal fistulae
3	Arseneau et al.,³³ United States	6MP/met + 3 infusions of IFX + 6MP as second-line therapy (intervention 1) ICER v. 6MP/met = US $355,450/QALY gained IFX + episodic reinfusion v. 6MP/met (intervention 2) ICER = US $360,900 6MP/met + IFX as second-line therapy (intervention 3) ICER = US $377,000
4	Baji et al.,³⁴ Belgium, France, Germany, Hungary, Italy, Spain, Sweden, Netherlands, United Kingdom	Cost-effectiveness of biological treatment sequences for fistulising Crohn’s disease across Europe
4		ICER of bsIFX (most cost-effective single treatment) v. standard care: Belgium: €38,420/QALY gained; France: €43,721/QALY gained; Germany: €72,551/QALY gained; Hungary: €34,684/QALY gained; Italy: €44,059/QALY gained; Netherlands: €59,101/QALY gained; Spain: €54,427/QALY gained; Sweden: €69,491/QALY gained; UK: €63,908/QALY gained; ICER of IFX v. standard care: Belgium: €38,420/QALY gained; France: €43,721/QALY gained; Germany: €95,540/QALY gained; Hungary: €49,286/QALY gained; Italy: €58,215/QALY gained; Netherlands: €59,101/QALY gained; Spain: €64,898/QALY gained; Sweden: €79,663/QALY gained; UK: €69,793/QALY gained; bsIFX v. bsIFX + ADA, bsIFX v. bsIFX + VEDO, bsIFX + ADA v. bsIFX + ADA + VEDO also reported
5	Bashir et al.,³⁵ Canada	Cost-effectiveness and clinical outcomes of early anti-tumor necrosis factor-alpha intervention in pediatric Crohn’s disease
5	Bashir et al.,³⁵ Canada	ICER public payer: CAD $2,756/wk in steroid-free remission gained Societal: CAD $2,968/wk in steroid-free remission gained
6	Beilman et al.,³⁶ Canada	Early initiation of tumor necrosis factor antagonist-based therapy for patients with Crohn’s disease reduces costs compared with late initiation
6	Beilman et al.,³⁶ Canada	NMB of early initiation of IFX = CAD $16,975 NMB of late initiation of IFX = NMB: −$103,184 Early v. late initiation of ADA also reported
7	Blackhouse et al.,³⁷ Canada	Canadian cost-utility analysis of initiation and maintenance treatment with anti-TNF-alpha drugs for refractory Crohn’s disease
7	Blackhouse et al.,³⁷ Canada	ICER of IFX v. usual care = CAD $222,955/QALY gained ICER of ADA v. usual care = CAD $193,305/QALY gained ICER of IFX v. ADA = CAD $451,165/QALY gained
8	Bolin et al.,³⁸ Sweden	The cost-effectiveness of biological therapy cycles in the management of Crohn’s disease
8	Bolin et al.,³⁸ Sweden	ICER of continued combination with IFX + metabolites (treatment 1) v. withdrawal of IFX (treatment 2) = SEK 755, 449/QALY gained ICER of treatment 1 v. continued IFX – metabolites (treatment arm 3) = SEK −79,933
9	Candia et al.,³⁹ Canada	Cost-utility analysis: thiopurines plus endoscopy-guided biological step-up therapy is the optimal management of postoperative Crohn’s disease
9	Candia et al.,³⁹ Canada	ICER of thiopurines postsurgery plus endoscopy-guided biological step-up therapy v. endoscopy-guided full step-up therapy = CAD $26,305/QALY gained
10	Catt et al.,⁴⁰ United Kingdom	Value assessment and quantitative benefit-risk modelling of biosimilar infliximab for Crohn’s disease
10	Catt et al.,⁴⁰ United Kingdom	INHB of bsIFX v. originator IFX = 0.04
11	Chen et al.,⁴¹ China	Cost-effectiveness of reimbursing infliximab for moderate to severe Crohn’s disease in China
11	Chen et al.,⁴¹ China	ICER of reimbursing IFX v. not reimbursing IFX = ¥42,198/QALY gained
12	de Groof et al.,⁴² Netherlands	Cost-effectiveness of laparoscopic ileocecal resection versus infliximab treatment of terminal ileitis in Crohn’s disease: the LIR!C trial
12	de Groof et al.,⁴² Netherlands	ICER of laparoscopic resection v. IFX (QALYs): €−85, 802/QALY; laparoscopic ileocecal resection was dominant
13	Hernandez et al.,⁴³ Japan	Cost-effectiveness analysis of vedolizumab compared with other biologics in anti-TNF-naive patients with moderate-to-severe ulcerative colitis in Japan
13	Hernandez et al.,⁴³ Japan	ICER of VEDO v. IFX = ¥4,687,692/QALY gained ICER of VEDO v. ADA = ¥4,821,940/QALY gained
14	Hughes et al.,⁴⁴ Canada	Cost-utility analysis of switching from reference to biosimilar infliximab compared to maintaining reference infliximab in adult patients with Crohn’s disease.
14	Hughes et al.,⁴⁴ Canada	Switching to bsIFX was less costly with incremental savings of CAD $46,194 and loss in QALYs of −0.13.
15	Jaisson-Hot et al.,⁴⁵ France	Management for severe Crohn’s disease: a lifetime cost-utility analysis.
15	Jaisson-Hot et al.,⁴⁵ France	ICER of IFX episodic retreatment v. conventional therapy = €63,700.82/QALY gained; ICER of IFX maintenance infusions every 8 wk v. conventional therapy = €784,057.49/QALY
16	Kaplan et al.,⁴⁶ United States	Infliximab dose escalation v. initiation of adalimumab for loss of response in Crohn’s disease: a cost-effectiveness analysis
16	Kaplan et al.,⁴⁶ United States	ICER of IFX dose escalation v. ADA = US $332,032/QALY gained
17	Marchetti et al.,⁴⁷ Italy	Cost-effectiveness analysis of top-down versus step-up strategies in patients with newly diagnosed active luminal Crohn’s disease
17	Marchetti et al.,⁴⁷ Italy	Top down IFX v. step-up IFX was dominant and had a cost savings of €773 and increased 0.14 QALYs
18	Moradi et al.,⁴⁸ Iran	Economic evaluation of infliximab for treatment of refractory ulcerative colitis in Iran: cost-effectiveness analysis
18	Moradi et al.,⁴⁸ Iran	ICER of IFX v. conventional treatment = US $240,903/QALY gained
19	Park et al.,⁴⁹ United States	Cost-effectiveness analysis of adjunct VSL# 3 therapy versus standard medical therapy in pediatric ulcerative colitis
19	Park et al.,⁴⁹ United States	ICER of standard care + VSL #3 v. standard therapy = US $79,910/QALY gained
20	Park et al.,⁵⁰ United States	Cost-effectiveness of early colectomy with ileal pouch-anal anastomosis versus standard medical therapy in severe ulcerative colitis
20	Park et al.,⁵⁰ United States	ICER of standard therapy + IPAA v. standard therapy = US $1,476,783/QALY gained
21	Rencz et al.,⁵¹ Belgium, France, Germany, Hungary, Italy, Netherlands, Spain, Sweden, United Kingdom	Cost-utility of biological treatment sequences for luminal Crohn’s disease in Europe
21		ICER of bsIFX v. standard care: Belgium = €37,545/QALY gained; France = €42,951/QALY gained; Germany = €72,147/QALY gained; Hungary = €34,580/QALY gained; Italy = €43,277/QALY gained; Netherlands = €58,912/QALY gained; Spain = €54,603/QALY gained; Sweden = €77,062/QALY gained; UK = €65,548/QALY gained ICER of IFX v. standard care: Belgium = €37,545/QALY gained; France = €42,951/QALY gained; Germany = €94,847/QALY gained; Hungary = €48,931/QALY gained; Italy = €57,267/QALY gained; Netherlands = €58,912/QALY gained; Spain = €64,943/QALY gained; Sweden = €87,118/QALY gained; UK = €71,353/QALY gained ICER of bsIFX + ADA v. bsIFX: Belgium = €76,385/QALY gained; France = €70,277/QALY gained; Germany = €162,069/QALY gained; Hungary = €79,360/QALY gained; Italy = €88,677/QALY gained; Netherlands = €92,260/QALY gained; Spain = €94,178/QALY gained; Sweden = €99,469/QALY gained; UK = €72,782/QALY gained ICER of bsIFX + VEDO v. bsIFX: Belgium = €183,963/QALY gained; France = €246,540/QALY gained; Germany = €257,969/QALY gained; Hungary = €256,937/QALY gained; Italy = €189,943/QALY gained; Netherlands = €179,875/QALY gained; Spain = €313,944/QALY gained; Sweden = €233,356/QALY gained; UK = €263,643/QALY gained bsIFX + ADA + VEDO v. bsIFX + ADA: Belgium = €212,182/QALY gained; France = €284,985/QALY gained; Germany = €298,431/QALY gained; Hungary = €296,376/QALY gained; Italy = €220,096/QALY gained; Netherlands = €206,266/QALY gained; Spain = €363,232/QALY gained; Sweden = €271,323/QALY gained; UK = €305,393/QALY gained Other treatment sequences also reported
22	Taleban et al.,⁵² United States	Colectomy with permanent end ileostomy is more cost-effective than ileal pouch-anal anastomosis for Crohn’s colitis
22	Taleban et al.,⁵² United States	ICER of IPAA v. permanent end ileostomy = US $70,715/QALY gained
23	Tang et al.,⁵³ United States	Cost-utility analysis of biologic treatments for moderate-to-severe Crohn’s disease
23	Tang et al.,⁵³ United States	IFX was dominant strategy compared with ADA, CERT, and NAT; cost of IFX = US $22,663 and effectiveness of IFX = 0.796 QALY gained; ICER not reported
24	Trigo-Vicente et al.,⁵⁴ Spain	Cost-effectiveness analysis of infliximab, adalimumab, golimumab, vedolizumab and tofacitinib for moderate to severe ulcerative colitis in Spain
24	Trigo-Vicente et al.,⁵⁴ Spain	ICER of bsIFX v. ADA = €43,928.07/QALY; bsIFX v. GOL = €31,340.69/QALY; bsIFX v. VEDO = €122, 890/QALY; bsIFX v. TOFAC = €270,503.19
25	Trigo-Vicente et al.,⁵⁵ Spain	Cost-effectiveness analysis of infliximab, adalimumab, golimumab and vedolizumab for moderate to severe ulcerative colitis in Spain
25	Trigo-Vicente et al.,⁵⁵ Spain	ICER of IFX v. ADA = €45,582/QALY; ADA v. GOL = €2,175,992; ADA v. VEDO = €90,532
26	Ung et al.,⁵⁶ Canada	Real-life treatment paradigms show infliximab is cost-effective for management of ulcerative colitis
26	Ung et al.,⁵⁶ Canada	ICER of IFX v. ongoing steroid medical therapy = US $71,000/QALY gained at 5 y; IFX dose escalation v. ongoing medical therapy = US $114,000 to US $306,000/QALY gained at 5 y
27	Vasudevan et al.,⁵⁷ United States	Cost-effectiveness of initial immunomodulators or infliximab using modern optimization strategies for Crohn’s disease in the biosimilar era
27	Vasudevan et al.,⁵⁷ United States	ICER for IFX + AZA v. AZA = US $511,384/QALY gained; ICER for IFX v. AZA = US $1,102,946/QALY
28	Velayos et al.,⁵⁸ United States	A test-based strategy is more cost effective than empiric dose escalation for patients with Crohn’s disease who lose responsiveness to infliximab
28	Velayos et al.,⁵⁸ United States	Testing strategy dominant compared with empiric dose escalation; testing strategy cost = US $31,870 with 0.801 QALYs; empiric dose escalation cost = US $37,266 with 0.800 QALYs
29	Yen et al.,⁵⁹ United States	Cost-effectiveness of 5-aminosalicylic acid therapy for maintenance of remission in ulcerative colitis
29	Yen et al.,⁵⁹ United States	ICER of maintenance 5-ASA with option of treatment escalation v. no maintenance 5-ASA and 5-ASA for flare with option of treatment escalation = US $224,000/QALY gained
30	Yokomizo et al.,⁶⁰ United States	Cost-effectiveness of adalimumab, infliximab or vedolizumab as first-line biological therapy in moderate-to-severe ulcerative colitis.
30	Yokomizo et al.,⁶⁰ United States	Cost of IFX = US $99,171/mucosal healing achieved; cost ADA = US $316,378/mucosal healing achieved; cost VEDO = US $301,969/mucosal healing achieved; ICER of 10 mg/kg IFX = ICER: US $1,243, 310/additional mucosal healing achieved
31	Yu et al.,⁶¹ United States	Cost utility of adalimumab versus infliximab maintenance therapies in the United States for moderately to severely active Crohn’s disease
31	Yu et al.,⁶¹ United States	ADA was dominant; ADA greater QALYs = 0.014 compared with IFX; ADA less cost = US −$4,852 compared with IFX

5-ASA, 5–aminosalicylic acid; 6MP, 6-mercaptopurine; ADA, adalimumab; AZA, azathioprine; bsIFX, biosimilar infliximab; CERT, certolizumab pegol; GOL, golimumab; ICER, incremental cost-effectiveness ratio; IFX, infliximab; INHB, incremental net health benefit; IPAA, early colectomy with ileal pouch-anal anastomosis; MET, metronidazole; NAT, natalizumab; NMB, net monetary benefit; QALY, quality-adjusted life year; TOFAC, tofacitinib; UK, United Kingdom; UST, ustekinumab; VEDO, vedolizumab.