Economic evaluation of tocilizumab monotherapy compared to adalimumab monotherapy in the treatment of severe active rheumatoid arthritis

Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research
Josh J CarlsonSean D Sullivan

Abstract

To estimate the cost-effectiveness of tocilizumab (TCZ) monotherapy (Mono) versus adalimumab (ADA) Mono from the US payer perspective in patients with rheumatoid arthritis for whom methotrexate is inappropriate. We compared TCZ Mono (8 mg/kg monthly) with ADA Mono (40 mg every other week), using efficacy results from a head-to-head study, ADalimumab ACTemrA (ADACTA). We calculated the incremental cost per responder (achievement of American College of Rheumatology [ACR] 20% improvement criteria, ACR 50% improvement criteria, ACR 70% improvement criteria, or low disease activity score) for TCZ versus ADA at 6 months. A patient-level simulation was used to estimate the lifetime incremental cost per quality-adjusted life-year (QALY) of initiating treatment with TCZ Mono versus ADA Mono. Both drugs are followed by an etanercept-certolizumab-palliative care sequence. Nonresponders discontinue at 6 months; responders experience a constant probability of discontinuation. Discontinuers move to the next treatment. ACR responses produce changes in the Health Assessment Questionnaire (HAQ) score. We mapped the HAQ score to utility to estimate QALYs. Costs include those related to hospitalization and those related to treatment (drug acquisi...Continue Reading

References

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Citations

Mar 16, 2017·Journal of Medical Economics·Jeroen P JansenVibeke Strand
Dec 28, 2018·Journal of Managed Care & Specialty Pharmacy·Melanie D WhittingtonJonathan D Campbell
Mar 28, 2020·Expert Review of Pharmacoeconomics & Outcomes Research·Max SchlueterWalid Fakhouri
Jan 24, 2020·Journal of Medical Economics·Matthew SussmanJoseph Menzin

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