Comparison of the cost-effectiveness of infliximab in the treatment of ankylosing spondylitis in the United Kingdom based on two different clinical trials

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Comparison of the cost-effectiveness of infliximab in the treatment of ankylosing spondylitis in the United Kingdom based on two different clinical trials. / Kobelt, Gisela; Sobocki, Patrik; Sieper, Joachim; Braun, Juergen.

In: International Journal of Technology Assessment in Health Care, Vol. 23, No. 3, 2007, p. 368-375.

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TY - JOUR

T1 - Comparison of the cost-effectiveness of infliximab in the treatment of ankylosing spondylitis in the United Kingdom based on two different clinical trials

AU - Kobelt, Gisela

AU - Sobocki, Patrik

AU - Sieper, Joachim

AU - Braun, Juergen

PY - 2007

Y1 - 2007

N2 - Objectives: To compare the cost-effectiveness of the treatment of ankylosing spondylitis (AS) with infliximab in the United Kingdom over lifetime estimated from two different clinical trials and adjusted for clinical practice guidelines. Methods: A cost-effectiveness model was developed to incorporate clinical, epidemiological, and economic data and allow extrapolation of trial results and incorporation of long-term treatment. Assumptions regarding treatment beyond the trials were based on open extensions from the trials and treatment guidelines by the British Society for Rheumatology. Results are presented for both the societal perspective and the perspective of the National Health Service (UK pound, discounted 3.5 percent). Results: Under the assumption that disease activity would be controlled and functional capacity would remain stable while on drug, treatment with infliximab (5 mg/kg every 6 weeks) dominates standard treatment in the societal perspective. In the National Health Service perspective, the cost per quality-adjusted life-year (QALY) gained over lifetime was 28,300 pound and 26,800 pound for the two trials. If functional capacity were to deteriorate at half the rate of untreated patients, the cost per QALY gained would be 35,300 pound and 34,11 pound 00, respectively. The results are sensitive to the dosing regimen adopted, the discontinuation rate, and assumptions concerning disease progression while on treatment. Conclusions: The two clinical trials yield the same cost-effectiveness results and the cost per QALY gained with treatment was found to be in the acceptable range.

AB - Objectives: To compare the cost-effectiveness of the treatment of ankylosing spondylitis (AS) with infliximab in the United Kingdom over lifetime estimated from two different clinical trials and adjusted for clinical practice guidelines. Methods: A cost-effectiveness model was developed to incorporate clinical, epidemiological, and economic data and allow extrapolation of trial results and incorporation of long-term treatment. Assumptions regarding treatment beyond the trials were based on open extensions from the trials and treatment guidelines by the British Society for Rheumatology. Results are presented for both the societal perspective and the perspective of the National Health Service (UK pound, discounted 3.5 percent). Results: Under the assumption that disease activity would be controlled and functional capacity would remain stable while on drug, treatment with infliximab (5 mg/kg every 6 weeks) dominates standard treatment in the societal perspective. In the National Health Service perspective, the cost per quality-adjusted life-year (QALY) gained over lifetime was 28,300 pound and 26,800 pound for the two trials. If functional capacity were to deteriorate at half the rate of untreated patients, the cost per QALY gained would be 35,300 pound and 34,11 pound 00, respectively. The results are sensitive to the dosing regimen adopted, the discontinuation rate, and assumptions concerning disease progression while on treatment. Conclusions: The two clinical trials yield the same cost-effectiveness results and the cost per QALY gained with treatment was found to be in the acceptable range.

KW - Kingdom

KW - United

KW - ankylosing spondylitis

KW - infliximab

KW - cost-effectiveness

KW - QALY

U2 - 10.1017/S0266462307070432

DO - 10.1017/S0266462307070432

M3 - Article

VL - 23

SP - 368

EP - 375

JO - International Journal of Technology Assessment in Health Care

JF - International Journal of Technology Assessment in Health Care

SN - 1471-6348

IS - 3

ER -