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

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

Research output: Contribution to journalArticle

25 Scopus citations

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 1 2009

Keywords

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

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Fingerprint Dive into the research topics of 'Cost-effectiveness of adalimumab for the maintenance of remission in patients with Crohn's disease'. Together they form a unique fingerprint.

  • Cite this