Cost-effectiveness of adalimumab for the maintenance of remission in patients with Crohn's disease

Edward Vincent Loftus, Jr, Scott J. Johnson, Andrew P. Yu, Eric Q. Wu, Jingdong Chao, Parvez M. Mulani

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

OBJECTIVE: Adalimumab is a fully human, monoclonal antibody clinically effective for the treatment of active Crohn's disease. The cost-effectiveness of adalimumab versus conventional, nonbiologic pharmacotherapies is unknown. This study evaluated the cost-effectiveness of adalimumab versus conventional, nonbiologic pharmacotherapies in the maintenance of Crohn's disease. METHODS: Trial data from two randomized controlled studies [Crohn's Trial of the Fully Human Antibody Adalimumab for Remission Maintenance (CHARM) and CLinical Assessment of Adalimumab Safety and Efficacy Studied as Induction Therapy in Crohn's Disease (CLASSIC I)] were analyzed within a cost-utility framework using a 1-year horizon from the perspective of the National Health Service (UK). The treatment efficacy and use for the adalimumab arm were based on observations from CHARM. A regression model used data from CLASSIC I to predict efficacy in patients who received nonbiologic pharmacotherapy. Unit costs of drugs, hospitalization, and other medical resources were derived from the literature. Primary standard gamble-calculated data were used to derive health-utility estimates. RESULTS: Compared with conventional, nonbiologic pharmacotherapy, adalimumab seemed to be cost-effective for the treatment of patients with severe disease and moderate-to-severe disease. The 56-week incremental cost-effectiveness ratio was £16 064/quality-adjusted life-year and £33 731/quality-adjusted life-year for severe and moderate-to-severe groups, respectively. Sensitivity analyses showed that the findings were robust. In the treatment of patients over their lifetimes, the incremental cost-effectiveness ratio was £6550/quality-adjusted life-year and £17 873/quality-adjusted life-year for patients with severe Crohn's disease and those with moderate-to-severe Crohn's disease, respectively. CONCLUSION: Adalimumab maintenance therapy seems to be cost-effective versus conventional, nonbiologic therapies for the maintenance of remission in patients with active Crohn's disease.

Original languageEnglish (US)
Pages (from-to)1302-1309
Number of pages8
JournalEuropean Journal of Gastroenterology and Hepatology
Volume21
Issue number11
DOIs
StatePublished - Nov 2009

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Crohn Disease
Cost-Benefit Analysis
Maintenance
Quality-Adjusted Life Years
Drug Therapy
Therapeutics
Costs and Cost Analysis
Drug Costs
Adalimumab
National Health Programs
Health Care Costs
Hospitalization
Monoclonal Antibodies
Safety
Antibodies
Health

Keywords

  • Adalimumab
  • Cost-effectiveness
  • Crohns disease
  • Tumor necrosis factor antagonist
  • Utility

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

Cite this

Cost-effectiveness of adalimumab for the maintenance of remission in patients with Crohn's disease. / Loftus, Jr, Edward Vincent; Johnson, Scott J.; Yu, Andrew P.; Wu, Eric Q.; Chao, Jingdong; Mulani, Parvez M.

In: European Journal of Gastroenterology and Hepatology, Vol. 21, No. 11, 11.2009, p. 1302-1309.

Research output: Contribution to journalArticle

Loftus, Jr, Edward Vincent ; Johnson, Scott J. ; Yu, Andrew P. ; Wu, Eric Q. ; Chao, Jingdong ; Mulani, Parvez M. / Cost-effectiveness of adalimumab for the maintenance of remission in patients with Crohn's disease. In: European Journal of Gastroenterology and Hepatology. 2009 ; Vol. 21, No. 11. pp. 1302-1309.
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AU - Chao, Jingdong

AU - Mulani, Parvez M.

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