School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, China.
Medical Affairs, Takeda (China) International Trading Company, Beijing, China.
Front Public Health. 2021 Aug 20;9:704889. doi: 10.3389/fpubh.2021.704889. eCollection 2021.
To evaluate the cost effectiveness of vedolizumab vs. infliximab in the treatment of anti-tumor necrosis factor-alpha (TNF-α)-naïve patients with moderate-to-severe active ulcerative colitis (UC) in China. The costs and effectiveness of vedolizumab and infliximab in the treatment of anti-TNF-α naïve patients with moderate-to-severe active UC were compared using a hybrid decision tree model and a Markov model. From the perspective of the Chinese healthcare system, this study simulated the lifetime health benefits [quality-adjusted life-years (QALYs)] and costs (USD) for patients with UC from the induction phase to the maintenance phase, with an annual discount rate of 5%. The clinical efficacy and transition probability data were based on a previously published network meta-analysis. The health utility, surgical risk, biologic drug discontinuation rate, and mortality were derived from previous literature and the Chinese statistical yearbook. The cost data were based on China's drug purchase and biding platform and the results of a survey sent to clinicians in 18 tertiary hospitals. One-way and probabilistic sensitivity analyses (PSAs) were performed to validate the robustness of the models' assumptions and specific parameter estimates. The results of the base-case analyses showed that compared with infliximab, vedolizumab led to a gain of 0.25 QALYs (9.56 vs. 9.31 QALYs) and was less expensive by $7,349 ($180,138 vs. 187,487), indicating that the use of vedolizumab was a dominant strategy. The results of one-way sensitivity analyses suggested that the annual discount rate and health-state costs had the greatest impact, but the results were otherwise consistent with those of the base-case analyses. The PSAs suggested that vedolizumab had a 98.6% probability of being effective at a threshold of 3 times the gross domestic product (GDP) per capita in China in 2020. Compared with infliximab, vedolizumab appears to be a more cost-effective option in the treatment of anti-TNF-α naïve adult patients with moderate-to-severe, active UC in China.
评估维得利珠单抗与英夫利昔单抗在治疗中国初治中重度活动型溃疡性结肠炎（UC）患者中的成本效果。采用混合决策树模型和马尔可夫模型比较了维得利珠单抗和英夫利昔单抗治疗初治中重度活动型 UC 患者的成本和效果。本研究从中国医疗保健系统的角度出发，模拟了诱导期至维持期 UC 患者的终生健康效益（质量调整生命年，QALY）和成本（美元），贴现率为 5%。临床疗效和转移概率数据基于先前发表的网络荟萃分析。健康效用、手术风险、生物药物停药率和死亡率来源于既往文献和中国统计年鉴。成本数据基于中国药品采购和招标平台以及对 18 家三级医院临床医生的调查结果。进行了单因素敏感性分析（PSA）和概率敏感性分析（PSA），以验证模型假设和特定参数估计的稳健性。基于基本情况分析结果显示，与英夫利昔单抗相比，维得利珠单抗使 QALY 增加 0.25 个（9.56 比 9.31），且成本降低 7349 美元（180138 比 187487），表明使用维得利珠单抗是一种优势策略。单因素敏感性分析结果表明，年度贴现率和健康状态成本对结果的影响最大，但与基本情况分析结果一致。PSA 结果提示，在中国 2020 年人均国内生产总值（GDP）的 3 倍阈值下，维得利珠单抗有 98.6%的概率是有效的。与英夫利昔单抗相比，维得利珠单抗在中国初治中重度、活动型 UC 成年患者的治疗中可能具有更高的成本效益。
Zotero 插件
