Real-world cost-effectiveness associated with infliximab maintenance therapy for moderate to severe Crohn's disease in China
©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved..
BACKGROUND: Infliximab was the first approved biologic treatment for moderate to severe Crohn's disease (MS-CD) in China. However, the cost-effectiveness of infliximab maintenance therapy (IMT) for MS-CD relative to conventional maintenance therapy remained unclarified.
AIM: To assess the cost-effectiveness of IMT for MS-CD in Chinese patients from the perspective of Chinese public insurance payer.
METHODS: A cohort of MS-CD patients managed in a Chinese tertiary care hospital was created to compare IMT with conventional maintenance therapy (CMT) for clinical outcomes and direct medical costs over a 1-year observation time using conventional regression analyses. A decision-analytic model with the generated evidence was constructed to assess the cost-effectiveness of IMT relative to CMT using reimbursed medical costs.
RESULTS: Based on the included 389 patients, IMT was associated with significantly higher disease remission chance [odds ratio: 4.060, P = 0.003], lower risk of developing new complications (odds ratio: 0.527, P = 0.010), higher utility value for quality of life (coefficient 0.822, P = 0.008), and lower total hospital costs related to disease management (coefficient -0.378, P = 0.008) than CMT. Base-case cost-effectiveness analysis estimated that IMT could cost Chinese health insurance payers ¥55260 to gain one quality-adjusted life year (QALY). The cost-effectiveness of IMT was mainly driven by the estimate of quality of life, treatment efficacy of maintenance therapy, mortality risk associated with active disease, and unit price of infliximab. The probability that IMT was cost-effective at a willingness-to-pay threshold of three times gross domestic product [2018 Chinese gross domestic product per capita (GDPPC)] was 86.4%.
CONCLUSION: IMT significantly improved real-world health outcomes and cost the Chinese public health insurance payers less than one GDPPC to gain one QALY in Chinese MS-CD patients.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2020 |
|---|---|
| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:26 |
|---|---|
| Enthalten in: |
World journal of gastroenterology - 26(2020), 41 vom: 07. Nov., Seite 6455-6474 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Shi, Ji-Hao [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
B72HH48FLU |
|---|
| Anmerkungen: |
Date Completed 14.05.2021 Date Revised 14.05.2021 published: Print Citation Status MEDLINE |
|---|
| doi: |
10.3748/wjg.v26.i41.6455 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM318107023 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM318107023 | ||
| 003 | DE-627 | ||
| 005 | 20231225164649.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2020 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.3748/wjg.v26.i41.6455 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1060.xml |
| 035 | |a (DE-627)NLM318107023 | ||
| 035 | |a (NLM)33244205 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Shi, Ji-Hao |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Real-world cost-effectiveness associated with infliximab maintenance therapy for moderate to severe Crohn's disease in China |
| 264 | 1 | |c 2020 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 14.05.2021 | ||
| 500 | |a Date Revised 14.05.2021 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: Infliximab was the first approved biologic treatment for moderate to severe Crohn's disease (MS-CD) in China. However, the cost-effectiveness of infliximab maintenance therapy (IMT) for MS-CD relative to conventional maintenance therapy remained unclarified | ||
| 520 | |a AIM: To assess the cost-effectiveness of IMT for MS-CD in Chinese patients from the perspective of Chinese public insurance payer | ||
| 520 | |a METHODS: A cohort of MS-CD patients managed in a Chinese tertiary care hospital was created to compare IMT with conventional maintenance therapy (CMT) for clinical outcomes and direct medical costs over a 1-year observation time using conventional regression analyses. A decision-analytic model with the generated evidence was constructed to assess the cost-effectiveness of IMT relative to CMT using reimbursed medical costs | ||
| 520 | |a RESULTS: Based on the included 389 patients, IMT was associated with significantly higher disease remission chance [odds ratio: 4.060, P = 0.003], lower risk of developing new complications (odds ratio: 0.527, P = 0.010), higher utility value for quality of life (coefficient 0.822, P = 0.008), and lower total hospital costs related to disease management (coefficient -0.378, P = 0.008) than CMT. Base-case cost-effectiveness analysis estimated that IMT could cost Chinese health insurance payers ¥55260 to gain one quality-adjusted life year (QALY). The cost-effectiveness of IMT was mainly driven by the estimate of quality of life, treatment efficacy of maintenance therapy, mortality risk associated with active disease, and unit price of infliximab. The probability that IMT was cost-effective at a willingness-to-pay threshold of three times gross domestic product [2018 Chinese gross domestic product per capita (GDPPC)] was 86.4% | ||
| 520 | |a CONCLUSION: IMT significantly improved real-world health outcomes and cost the Chinese public health insurance payers less than one GDPPC to gain one QALY in Chinese MS-CD patients | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Cost-effectiveness | |
| 650 | 4 | |a Crohn’s disease | |
| 650 | 4 | |a Direct medical costs | |
| 650 | 4 | |a Infliximab | |
| 650 | 4 | |a Maintenance therapy | |
| 650 | 4 | |a Outcomes | |
| 650 | 7 | |a Infliximab |2 NLM | |
| 650 | 7 | |a B72HH48FLU |2 NLM | |
| 700 | 1 | |a Luo, Liang |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Xiao-Li |e verfasserin |4 aut | |
| 700 | 1 | |a Pan, Yi-Peng |e verfasserin |4 aut | |
| 700 | 1 | |a Zhang, Zhou |e verfasserin |4 aut | |
| 700 | 1 | |a Fang, Hao |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Ying |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Wen-Dong |e verfasserin |4 aut | |
| 700 | 1 | |a Cao, Qian |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t World journal of gastroenterology |d 1997 |g 26(2020), 41 vom: 07. Nov., Seite 6455-6474 |w (DE-627)NLM117065250 |x 2219-2840 |7 nnns |
| 773 | 1 | 8 | |g volume:26 |g year:2020 |g number:41 |g day:07 |g month:11 |g pages:6455-6474 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.3748/wjg.v26.i41.6455 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 26 |j 2020 |e 41 |b 07 |c 11 |h 6455-6474 | ||