Real-Life Treatment Paradigms Show Adalimumab Is Cost-Effective for the Management of Ulcerative Colitis.
Real-Life Treatment Paradigms Show Adalimumab Is Cost-Effective for the Management of Ulcerative Colitis.
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DOI：
10.1155/2016/5315798
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发表时间：
2016
影响因子：
2.7
通讯作者：
Fedorak RN
中科院分区：
文献类型：
--
作者：
Beilman CL;Thanh NX;Ung V;Ma C;Wong K;Kroeker KI;Lee T;Wang H;Ohinmaa A;Jacobs P;Halloran BP;Fedorak RN
背景阿达木单抗可有效维持中重度溃疡性结肠炎（UC）患者的缓解。目前，生物疗法用于常规药物治疗失败的患者。如果没有生物疗法，患者通常选择保持不适状态，而不是接受结肠切除术。Objective.本研究的目的是评价阿达木单抗在阿达木单抗容易获得的UC患者与阿达木单抗不可获得的UC患者中的成本-效果。方法.先前验证的马尔可夫模型用于模拟糖皮质激素依赖性和/或对巯基嘌呤治疗无反应的UC患者的疾病进展。使用随机对照试验和现实生活中的观察性研究的数据，确定健康状态之间的效用评分和转移概率。费用来自安大略病例成本计算倡议和阿尔伯塔医疗福利健康计划。结果在5年和10年的治疗时间范围内，与在不适状态下进行药物治疗相比，阿达木单抗治疗UC的增量成本-效果比分别为40，000美元/质量调整生命年和59，000美元/质量调整生命年。结论考虑到现实生活中患者避免结肠切除术的偏好，阿达木单抗治疗UC的支付意愿阈值为80，000美元，具有成本效益。
Background. Adalimumab is effective for the maintenance of remission in patients with moderate-to-severe ulcerative colitis (UC). Currently, biologic therapies are used in cases where patients fail conventional medical therapies. If biologic therapies are not available, patients often choose to remain in an unwell state rather than undergo colectomy. Objective. The aim of the study was to evaluate the cost-effectiveness of adalimumab in patients with UC where adalimumab was readily available compared to not available. Methods. A previously validated Markov model was used to simulate disease progression of patients with UC who are corticosteroid-dependent and/or did not respond to thiopurine therapy. Utility scores and transition probabilities between health states were determined by using data from randomized controlled trials and real-life observational studies. Costs were obtained from the Ontario Case Costing Initiative and the Alberta Health Schedule of Medical Benefits. Results. The incremental cost-effectiveness ratios for readily available adalimumab treatment of UC were $40,000 and $59,000 per quality-adjusted life year, compared with ongoing medical therapy in an unwell state, at 5-year and 10-year treatment time horizons, respectively. Conclusion. Considering real-life patient preferences to avoid colectomy, adalimumab is cost-effective according to a willingness-to-pay threshold of $80,000 for treatment of UC.
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影响因子：
12.6
作者：
Arseneau, Kristen O.;Sultan, Shahnaz;Cominelli, Fabio
通讯作者：
Cominelli, Fabio
DOI：
10.1097/meg.0b013e3283525a7b
发表时间：
2012-07-01
影响因子：
2.1
作者：
Barreiro-de Acosta, Manuel;Garcia-Bosch, Orlando;Marin-Jimenez, Ignacio
通讯作者：
Marin-Jimenez, Ignacio
影响因子：
8
作者：
Blackhouse, Gord;Assasi, Nazila;Goeree, Ron
通讯作者：
Goeree, Ron
影响因子：
29.4
作者：
Panaccione, Remo;Ghosh, Subrata;Rutgeerts, Paul
通讯作者：
Rutgeerts, Paul
影响因子：
3
作者：
Arai, K;Koganei, K;Fukushima, T
通讯作者：
Fukushima, T