title: Real-Life Treatment Paradigms Show Adalimumab Is Cost-Effective for the Management of Ulcerative Colitis.
abstract: Background. Adalimumab is effective for the maintenance of remission in patients with moderate-to-severe ulcerative colitis (UC). Currently, biologic therapies are used in cases where patients fail conventional medical therapies. If biologic therapies are not available, patients often choose to remain in an unwell state rather than undergo colectomy.Objective. The aim of the study was to evaluate the cost-effectiveness of adalimumab in patients with UC where adalimumab was readily available compared to not available.Methods. A previously validated Markov model was used to simulate disease progression of patients with UC who are corticosteroid-dependent and/or did not respond to thiopurine therapy. Utility scores and transition probabilities between health states were determined by using data from randomized controlled trials and real-life observational studies. Costs were obtained from the Ontario Case Costing Initiative and the Alberta Health Schedule of Medical Benefits.Results. The incremental cost-effectiveness ratios for readily available adalimumab treatment of UC were $40,000 and $59,000 per quality-adjusted life year, compared with ongoing medical therapy in an unwell state, at 5-year and 10-year treatment time horizons, respectively.Conclusion. Considering real-life patient preferences to avoid colectomy, adalimumab is cost-effective according to a willingness-to-pay threshold of $80,000 for treatment of UC.
authors: Division of Gastroenterology, University of Alberta, Edmonton, AB, Canada.
authors: Candace L
authors: 0000-0002-6376-6578
authors: CL
authors: Beilman
authors: Institute of Health Economics, Edmonton, AB, Canada.
authors: Nguyen Xuan
authors: 0000-0001-6536-4321
authors: NX
authors: Thanh
authors: Division of Gastroenterology, University of Alberta, Edmonton, AB, Canada.
authors: Victoria
authors: V
authors: Ung
authors: Division of Gastroenterology, University of Alberta, Edmonton, AB, Canada.
authors: Christopher
authors: 0000-0002-4698-9948
authors: C
authors: Ma
authors: Division of Gastroenterology, University of Alberta, Edmonton, AB, Canada.
authors: Karen
authors: 0000-0002-5588-2229
authors: K
authors: Wong
authors: Division of Gastroenterology, University of Alberta, Edmonton, AB, Canada.
authors: Karen I
authors: KI
authors: Kroeker
authors: Division of Gastroenterology, University of Alberta, Edmonton, AB, Canada.
authors: Thomas
authors: T
authors: Lee
authors: Division of Gastroenterology, University of Alberta, Edmonton, AB, Canada.
authors: Haili
authors: H
authors: Wang
authors: Institute of Health Economics, Edmonton, AB, Canada.
authors: Arto
authors: 0000-0002-7094-1573
authors: A
authors: Ohinmaa
authors: Institute of Health Economics, Edmonton, AB, Canada.
authors: Phil
authors: P
authors: Jacobs
authors: Division of Gastroenterology, University of Alberta, Edmonton, AB, Canada.
authors: Brendan P
authors: BP
authors: Halloran
authors: Division of Gastroenterology, University of Alberta, Edmonton, AB, Canada.
authors: Richard N
authors: 0000-0002-7382-0080
authors: RN
authors: Fedorak
mesh_terms: D000068879:Adalimumab / Q000191:economics* / Q000627:therapeutic use; D000328:Adult; D000416:Alberta; D000893:Anti-Inflammatory Agents / Q000191:economics* / Q000627:therapeutic use; D003093:Colitis, Ulcerative / Q000188:drug therapy* / Q000191:economics; D003362:Cost-Benefit Analysis; D005260:Female; D006297:Health Services Accessibility / Q000191:economics; D006801:Humans; D008297:Male; D009864:Ontario; D019057:Quality-Adjusted Life Years; D012074:Remission Induction; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D000068879:Adalimumab