Cost-Effectiveness of Early Treatment with Originator Biologics or Their Biosimilars After Methotrexate Failure in Patients with Established Rheumatoid Arthritis

• DOI: 10.1007/s12325-019-00986-7
• Publication Date: 2019-05-30T12:02:40Z
• Authors: Dipen Patel; Ahmed Shelbaya; Raymond Cheung; Jyoti Aggarwal; Sang Hee Park; Javier Coindreau
• Keywords: Biosimilar

Evidence supports the clinical benefits of early aggressive biologic treatment in patients with rheumatoid arthritis (RA) who have an inadequate response to conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), but cost-effectiveness intervention originator biologics such as tumor necrosis factor inhibitors (TNFis) or their biosimilars has not been well studied. We developed a Markov model estimate lifetime costs and utilities for established RA do respond methotrexate (MTX) therapy. A analysis was conducted comparing standard pathway (addition TNFis MTX monotherapy at 12 months) two pathways (either addition biosimilar 6 months). Early TNFi months associated increases total £1692 0.10 quality-adjusted life-years (QALYs) per patient compared months, resulting incremental ratio (ICER) £17,335/QALY. increased by £70 QALYs ICER £713/QALY. Switching from combination therapy either after csDMARD failure cost-effective threshold £30,000/QALY. Pfizer Inc.