Advanced

Modeling the cost-effectiveness of treatment of rheumatoid arthritis with rituximab using registry data from Southern Sweden

Lindgren, Peter; Geborek, Pierre LU and Kobelt, Gisela LU (2009) In International Journal of Technology Assessment in Health Care 25(2). p.181-189
Abstract
Objectives: The aim of this study was to estimate the cost-effectiveness of rituximab in patients not responding adequately to the first tumor necrosis factor (TNF) inhibitor using a model constructed to predict resource consumption and health outcomes in a population-based registry of biological treatments in Southern Sweden (SSATG). Methods: The model was developed as a discrete event simulation model, using SSATG data for the years 1999-2007. The data set included 1,903 patients with complete data on treatments (up to three treatment lines), functional capacity (HAQ), disease activity (DAS28), and utility (EQ-5D). Resource consumption was based on a regular population-based survey of patients in Southern Sweden. Rituximab was... (More)
Objectives: The aim of this study was to estimate the cost-effectiveness of rituximab in patients not responding adequately to the first tumor necrosis factor (TNF) inhibitor using a model constructed to predict resource consumption and health outcomes in a population-based registry of biological treatments in Southern Sweden (SSATG). Methods: The model was developed as a discrete event simulation model, using SSATG data for the years 1999-2007. The data set included 1,903 patients with complete data on treatments (up to three treatment lines), functional capacity (HAQ), disease activity (DAS28), and utility (EQ-5D). Resource consumption was based on a regular population-based survey of patients in Southern Sweden. Rituximab was incorporated as second line treatment, using effectiveness data for the active group (N = 311) in a clinical trial comparing rituximab to placebo (REFLEX). It is thus compared to the mix of second line biologics used in SSATG. The analysis starts after failure of the first TNF inhibitor. Results are reported as costs ((sic)2008) per quality-adjusted life-year (QALY; both discounted 3 percent), for the societal perspective in Sweden. Results: Total costs in the rituximab strategy are estimated at (sic)401,100 compared with (sic)403,000 in the TNF-inhibitor arm. Total QALYs are 5.98 and 5.78, respectively. The findings were found to be robust in extensive sensitivity analysis. Conclusions: In our model, a strategy where rituximab is used as second line treatment after failure of the first TNF inhibitor provides a small saving (essentially due to the lower price of rituximab) and a QALY gain (due to better effect than the mix of second line TNF inhibitors). (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Sweden, Cost-effectiveness, Rheumatoid arthritis, Rituximab, RA registries
in
International Journal of Technology Assessment in Health Care
volume
25
issue
2
pages
181 - 189
publisher
Cambridge
external identifiers
  • wos:000265300600008
  • scopus:67549144693
ISSN
1471-6348
DOI
10.1017/S0266462309090230
language
English
LU publication?
yes
id
969fb7fc-1236-4124-9140-69e6fda215bb (old id 1399505)
date added to LUP
2009-06-15 15:16:04
date last changed
2017-10-01 03:36:33
@article{969fb7fc-1236-4124-9140-69e6fda215bb,
  abstract     = {Objectives: The aim of this study was to estimate the cost-effectiveness of rituximab in patients not responding adequately to the first tumor necrosis factor (TNF) inhibitor using a model constructed to predict resource consumption and health outcomes in a population-based registry of biological treatments in Southern Sweden (SSATG). Methods: The model was developed as a discrete event simulation model, using SSATG data for the years 1999-2007. The data set included 1,903 patients with complete data on treatments (up to three treatment lines), functional capacity (HAQ), disease activity (DAS28), and utility (EQ-5D). Resource consumption was based on a regular population-based survey of patients in Southern Sweden. Rituximab was incorporated as second line treatment, using effectiveness data for the active group (N = 311) in a clinical trial comparing rituximab to placebo (REFLEX). It is thus compared to the mix of second line biologics used in SSATG. The analysis starts after failure of the first TNF inhibitor. Results are reported as costs ((sic)2008) per quality-adjusted life-year (QALY; both discounted 3 percent), for the societal perspective in Sweden. Results: Total costs in the rituximab strategy are estimated at (sic)401,100 compared with (sic)403,000 in the TNF-inhibitor arm. Total QALYs are 5.98 and 5.78, respectively. The findings were found to be robust in extensive sensitivity analysis. Conclusions: In our model, a strategy where rituximab is used as second line treatment after failure of the first TNF inhibitor provides a small saving (essentially due to the lower price of rituximab) and a QALY gain (due to better effect than the mix of second line TNF inhibitors).},
  author       = {Lindgren, Peter and Geborek, Pierre and Kobelt, Gisela},
  issn         = {1471-6348},
  keyword      = {Sweden,Cost-effectiveness,Rheumatoid arthritis,Rituximab,RA registries},
  language     = {eng},
  number       = {2},
  pages        = {181--189},
  publisher    = {Cambridge},
  series       = {International Journal of Technology Assessment in Health Care},
  title        = {Modeling the cost-effectiveness of treatment of rheumatoid arthritis with rituximab using registry data from Southern Sweden},
  url          = {http://dx.doi.org/10.1017/S0266462309090230},
  volume       = {25},
  year         = {2009},
}