Cost-effectiveness of vedolizumab compared with infliximab, adalimumab, and golimumab in patients with ulcerative colitis in the United Kingdom
- 907 Downloads
To examine the clinical and economic impact of vedolizumab compared with infliximab, adalimumab, and golimumab in the treatment of moderately to severely active ulcerative colitis (UC) in the United Kingdom (UK).
A decision analytic model in Microsoft Excel was used to compare vedolizumab with other biologic treatments (infliximab, adalimumab, and golimumab) for the treatment of biologic-naïve patients with UC in the UK. Efficacy data were obtained from a network meta-analysis using placebo as the common comparator. Other inputs (e.g., unit costs, adverse-event disutilities, probability of surgery, mortality) were obtained from published literature. Costs were presented in 2012/2013 British pounds. Outcomes included quality-adjusted life-years (QALYs). Costs and outcomes were discounted by 3.5% per year. Incremental cost-effectiveness ratios were presented for vedolizumab compared with other biologics. Univariate and multivariate probabilistic sensitivity analyses were conducted to assess model robustness to parameter uncertainty.
The model predicted that anti-tumour necrosis factor-naïve patients on vedolizumab would accrue more QALY than patients on other biologics. The incremental results suggest that vedolizumab is a cost-effective treatment compared with adalimumab (incremental cost-effectiveness ratio of £22,735/QALY) and dominant compared with infliximab and golimumab. Sensitivity analyses suggest that results are most sensitive to treatment response and transition probabilities. However, vedolizumab is cost-effective irrespective of variation in any of the input parameters.
Our model predicted that treatment with vedolizumab improves QALY, increases time in remission and response, and is a cost-effective treatment option compared with all other biologics for biologic-naïve patients with moderately to severely active UC.
KeywordsUlcerative colitis Vedolizumab Cost-effectiveness Economics Inflammatory bowel disease
JEL ClassificationI (Health, Education, and Welfare)
Compliance with ethical standards
Conflict of interest
The research presented in this manuscript was funded by Takeda Pharmaceuticals, AG. Ms. Bergman, Ms. Chevrou-Severac, Mr. Selby, and Dr. Smyth are employees of Takeda. Dr. Kerrigan is an employee of PHMR Associates, a contract research organization that received funding from Takeda to conduct the analyses. Mr. Wilson is an employee of RTI Health Solutions, a contract research organization that received funding from Takeda to conduct the analyses.
Source of funding
The research presented in this manuscript was funded by Takeda Pharmaceuticals, AG.
- 2.National Institute for Health and Care Excellence (NICE). Clinical guidelines CG166: ulcerative colitis. https://www.nice.org.uk/guidance/cg166/chapter/introduction (2010). Accessed 29 August 2013
- 5.Kornbluth, A., Sachar, D.B.: Practice Parameters Committee of the American College of Gastroenterology. Ulcerative colitis practice guidelines in adults: American College of Gastroenterology, Practice Parameters Committee. J. Gastroenterol. 105(3), 501–523 (2010)Google Scholar
- 6.National Institutes of Health. Ulcerative colitis. http://www.nlm.nih.gov/medlineplus/ulcerativecolitis.html (2010). Accessed 4 Sept 2012
- 14.Sandborn, W., Sands, B., Rutgeerts, P., Sankoh, S., Rosario, M., Milch, C., et al.: Sustained therapeutic benefit of vedolizumab throughout one year in ulcerative colitis in GEMINI I, a randomized, placebo-controlled, double-blind, multicenter trial. J. Crohns Colitis. 7, S138–S139 (2013)CrossRefGoogle Scholar
- 16.Ling, C., Colosia, A., Vickers, A., Ainsworth, C.: Systematic literature review and network meta-analysis in ulcerative colitis. Revised final report. (Takeda data on file, 31 Jan 2014)Google Scholar
- 18.Office for National Statistics: Death registrations summary tables, England and Wales 2010. http://www.ons.gov.uk/ons/publications/re-reference-tables.html?edition=tcm%3A77-227638 (2011). Accessed 12 Feb 2012
- 20.Royal College of Physicians: National clinical audit of biological therapies: UK inflammatory bowel disease (IBD) audit. http://www.rcplondon.ac.uk/sites/default/files/national_clinical_audit_report_of_biological_therapies_-_adult_report._29_august_2013.pdf (2013). Accessed 29 Aug 2013
- 21.Department of Health: NHS reference costs 2011–12. https://www.gov.uk/government/publications/nhs-reference-costs-financial-year-2011-to-2012 (2013). Accessed April 2016
- 26.Final Clinical Study Report C13006: A phase 3, randomized, placebo-controlled, blinded, multicenter study of the induction and maintenance of clinical response and remission by vedolizumab (MLN0002) in patients with moderate to severe ulcerative colitis (September 2012)Google Scholar
- 28.British National Formulary. No. 66. 2013. http://www.bnf.org/bnf/go?bnf/current/December (2013). Accessed April 2016
- 29.Curtis, L.: Unit costs of health and social care 2012. http://www.pssru.ac.uk/archive/pdf/uc/uc2012/full-with-covers.pdf. Accessed 16 Dec 2013
- 32.Essat, M., Tappenden, P., Ren, S., Bessey, A., Archer, R., Wong, R., Lobo, A., Hoque, S.: Vedolizumab for the treatment of adults with moderate-to-severe active ulcerative colitis: an evidence review group perspective of a NICE single technology appraisal. Pharmacoeconomics 34(3), 245–257 (2016)CrossRefPubMedGoogle Scholar