Cost-utility analysis of certolizumab pegol in combination with methotrexate in patients with moderate-to-severe active rheumatoid arthritis in Greece

Rheumatology International
C TzanetakosN Maniadakis

Abstract

We aimed to evaluate the cost-effectiveness of certolizumab pegol (CZP), a pegylated fc-free anti-TNF, as add-on therapy to methotrexate (MTX) versus etanercept, adalimumab, or golimumab in patients with moderate-to-severe active rheumatoid arthritis (RA) not responding to the conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs). A Markov model (6-month cycle length) assessed health and cost outcomes of CZP versus other anti-TNFs recommended for RA in Greece over a patient's lifetime. Following discontinuation of first-line anti-TNF, patients switched to second anti-TNF and then to a biologic with another mode of action. Sequential use of csDMARDs followed third biologic. Clinical data and utilities were extracted from published literature. Analysis was conducted from third-party payer perspective in Greece. Costs (drug acquisition, administration, monitoring, and patient management) were considered for 2014. Results presented are incremental cost-effectiveness ratios (ICERs) per quality-adjusted life year (QALY). Probabilistic sensitivity analysis (PSA) ascertained robustness of base-case findings. Base-case analysis indicated that CZP+MTX was more costly and more effective compared with Etanercept+MTX (bas...Continue Reading

References

Apr 1, 1994·Arthritis and Rheumatism·F WolfeM A Cathey
Feb 20, 1999·Arthritis and Rheumatism·G KobeltB Jönsson
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Feb 28, 2009·Arthritis and Rheumatism·Wilbert B van den HoutFerdinand C Breedveld
May 1, 2009·Arthritis and Rheumatism·Sophie Martin Du PanUNKNOWN Swiss Clinical Quality Management Physicians
Mar 2, 2011·Clinical Rheumatology·Annelies Boonen, Johan L Severens
Dec 6, 2011·Best Practice & Research. Clinical Rheumatology·Bruno FautrelAnnelies Boonen

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