Tight control for Crohn's disease with adalimumab-based treatment is cost-effective: an economic assessment of the CALM trial
Tight control for Crohn's disease with adalimumab-based treatment is cost-effective: an economic assessment of the CALM trial
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DOI：
10.1136/gutjnl-2019-318256
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发表时间：
2020-04-01
期刊：
影响因子：
24.5
通讯作者：
D'Haens, Geert R.
中科院分区：
文献类型：
--
作者：
Panaccione, Remo;Colombel, Jean-Frederic;D'Haens, Geert R.
目的 从英国公共付款人的角度，评估炎症生物标志物和临床症状导向的严格控制策略 (TC) 与基于症状的临床管理 (CM) 相比，对于未接受过免疫抑制剂和生物制剂的克罗恩病 (CD) 患者的成本效益。设计回归模型，根据严格控制的效果估计每周基于 CD 活动指数 (CDAI) 的过渡矩阵（缓解：CDAI = 150 至 = 300 至 = 450）克罗恩病 (CALM) 试验的管理。回归预测住院治疗。卫生公用事业和成本适用于卫生状况。工作生产力被货币化并包含在敏感性分析中。计算缓解率、CD 相关住院、阿达木单抗注射、其他直接医疗费用、质量调整生命年 (QALY) 和增量成本效益比 (ICER)。 结果 在 48 周内，TC 与较高的临床缓解 (CDAI) 相关
Objective To evaluate the cost-effectiveness of an inflammatory biomarker and clinical symptom directed tight control strategy (TC) compared with symptom-based clinical management (CM) in patients with Crohn's disease (CD) naive to immunosuppressants and biologics using a UK public payer perspective.Design A regression model estimated weekly CD Activity Index (CDAI)-based transition matrices (remission: CDAI = 150 to = 300 to = 450) based on the Effect of Tight Control Management on Crohn's Disease (CALM) trial. A regression predicted hospitalisations. Health utilities and costs were applied to health states. Work productivity was monetised and included in sensitivity analyses. Remission rate, CD-related hospitalisations, adalimumab injections, other direct medical costs, quality-adjusted life-years (QALYs) and incremental cost-effectiveness ratio (ICER) were calculated.Results Over 48 weeks, TC was associated with a higher clinical remission (CDAI