Cost-Effectiveness of Vedolizumab as a First-Line Advanced Therapy Versus Adalimumab Treatment Sequences for Ulcerative Colitis in Italy.

Autor: Salcedo J; Takeda Pharmaceuticals U.S.A., Inc., 40 Landsdowne Street, Cambridge, MA, 02139, USA. jonathan.salcedo@takeda.com., Hill-McManus D; Putnam Associates, London, UK., Hardern C; Putnam Associates, London, UK., Opeifa O; Putnam Associates, London, UK., Viti R; Takeda Italy S.p.A., Rome, Italy., Siviero L; Takeda Italy S.p.A., Rome, Italy., Roscini AS; Takeda Italy S.p.A., Rome, Italy., Di Martino G; Takeda Italy S.p.A., Rome, Italy.
Jazyk: angličtina
Zdroj: PharmacoEconomics - open [Pharmacoecon Open] 2024 Sep; Vol. 8 (5), pp. 701-714. Date of Electronic Publication: 2024 Jun 11.
DOI: 10.1007/s41669-024-00497-4
Abstrakt: Background: Today, there are many treatment options available for the management of ulcerative colitis, creating challenges in selecting the most efficacious and cost-effective treatment sequences. Treatments in the anti-tumor necrosis factor alpha (TNFα) therapeutic class, as well as vedolizumab, are widely used and endorsed as first-line options according to treatment guidelines. The aim of this study was to compare treatment sequences involving vedolizumab and the anti-TNFα treatment adalimumab in terms of cost-effectiveness in the treatment of moderately to severely active ulcerative colitis in Italy.
Methods: A cost-effectiveness model comparing treatment sequences within the Italian National Health Service in terms of costs and quality-adjusted life years (QALYs) with a lifetime horizon was developed. The analysis focused on the relative positioning of vedolizumab and adalimumab, leveraging the results of the landmark head-to-head VARSITY clinical trial as key inputs. The robustness of the results was investigated through a range of sensitivity and scenario analyses.
Results: The strategy of vedolizumab as a first-line advanced therapy followed by adalimumab was associated with higher costs and health benefits compared with first-line adalimumab followed by vedolizumab. The incremental cost-effectiveness ratio was €16,146/QALY, which was found to be robust to changes to inputs associated with areas of high uncertainty.
Conclusion: This economic evaluation estimated a 94% probability that vedolizumab as a first-line advanced therapy is cost-effective at a threshold of €33,004/QALY when compared with first-line adalimumab sequences. Using clinical trial evidence to inform the efficacy of second-line treatments estimated that the effectiveness of anti-TNFα treatments is not substantially reduced by vedolizumab exposure.
(© 2024. The Author(s).)
Databáze: MEDLINE
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