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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 LU ; Sobocki, Patrik; Sieper, Joachim and Braun, Juergen (2007) In International Journal of Technology Assessment in Health Care 23(3). p.368-375
Abstract
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:... (More)
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. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Kingdom, United, ankylosing spondylitis, infliximab, cost-effectiveness, QALY
in
International Journal of Technology Assessment in Health Care
volume
23
issue
3
pages
368 - 375
publisher
Cambridge
external identifiers
  • wos:000247845800011
  • scopus:34250743029
ISSN
1471-6348
DOI
10.1017/S0266462307070432
language
English
LU publication?
yes
id
ff01921f-f68a-4308-9771-884d67db5c5e (old id 912499)
date added to LUP
2008-01-09 12:58:58
date last changed
2017-01-01 04:23:13
@article{ff01921f-f68a-4308-9771-884d67db5c5e,
  abstract     = {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.},
  author       = {Kobelt, Gisela and Sobocki, Patrik and Sieper, Joachim and Braun, Juergen},
  issn         = {1471-6348},
  keyword      = {Kingdom,United,ankylosing spondylitis,infliximab,cost-effectiveness,QALY},
  language     = {eng},
  number       = {3},
  pages        = {368--375},
  publisher    = {Cambridge},
  series       = {International Journal of Technology Assessment in Health Care},
  title        = {Comparison of the cost-effectiveness of infliximab in the treatment of ankylosing spondylitis in the United Kingdom based on two different clinical trials},
  url          = {http://dx.doi.org/10.1017/S0266462307070432},
  volume       = {23},
  year         = {2007},
}