Cost effectiveness of two therapeutic regimens of infliximab in ankylosing spondylitis: economic evaluation within a randomised controlled trial
Identifieur interne : 000970 ( Main/Exploration ); précédent : 000969; suivant : 000971Cost effectiveness of two therapeutic regimens of infliximab in ankylosing spondylitis: economic evaluation within a randomised controlled trial
Auteurs : B. Fautrel [France] ; M. Benhamou [France] ; M. Breban [France] ; C. Roy [France] ; C. Lenoir [France] ; G. Trape [France] ; A. Baleydier [France] ; P. Ravaud [France] ; M. Dougados [France]Source :
- Annals of the Rheumatic Diseases [ 0003-4967 ] ; 2010-02.
Abstract
Objective: To determine the incremental cost-effectiveness ratios (ICERs) of two therapeutic regimens of infliximab for ankylosing spondylitis (AS). Methods: 230 patients with active AS who were participating in a randomised controlled trial comparing two infliximab infusion modalities—every 6 weeks (Q6) and on demand (DEM)—were included in an economic evaluation within the trial. Data were collected by phone every 3 months for 1 year. Direct and indirect costs were calculated from a payer perspective. Health-related quality of life was assessed with a general health rating scale. ICERs were calculated for one 20% improvement (ASAS20), for one partial remission and for one quality-adjusted life year (QALY) gained. Results: The Q6 regimen was significantly more efficacious than the DEM regimen but also more costly (€22 388 vs €17 596; p<0.001), because it required significantly more infliximab infusions per patient (8.4 vs 6.2). The ICERs of the Q6 to DEM regimen were €15 841 for one ASAS20 response, €23 296 for one partial remission and €50 760 for one QALY gained. Conclusion: The administration of infliximab every 6 weeks is cost effective as compared with a DEM regimen; however, the ICER is close to the acceptability threshold of €50 000 for one QALY gained. Trial registration number: NCT 00439283.
Url:
DOI: 10.1136/ard.2008.103887
Affiliations:
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Methods: 230 patients with active AS who were participating in a randomised controlled trial comparing two infliximab infusion modalities—every 6 weeks (Q6) and on demand (DEM)—were included in an economic evaluation within the trial. Data were collected by phone every 3 months for 1 year. Direct and indirect costs were calculated from a payer perspective. Health-related quality of life was assessed with a general health rating scale. ICERs were calculated for one 20% improvement (ASAS20), for one partial remission and for one quality-adjusted life year (QALY) gained. Results: The Q6 regimen was significantly more efficacious than the DEM regimen but also more costly (€22 388 vs €17 596; p<0.001), because it required significantly more infliximab infusions per patient (8.4 vs 6.2). The ICERs of the Q6 to DEM regimen were €15 841 for one ASAS20 response, €23 296 for one partial remission and €50 760 for one QALY gained. Conclusion: The administration of infliximab every 6 weeks is cost effective as compared with a DEM regimen; however, the ICER is close to the acceptability threshold of €50 000 for one QALY gained. Trial registration number: NCT 00439283.</div></front></TEI><affiliations><list><country><li>France</li></country><region><li>Île-de-France</li></region><settlement><li>Boulogne-Billancourt</li><li>Paris</li></settlement></list><tree><country name="France"><noRegion><name sortKey="Fautrel, B" sort="Fautrel, B" uniqKey="Fautrel B" first="B" last="Fautrel">B. Fautrel</name></noRegion><name sortKey="Baleydier, A" sort="Baleydier, A" uniqKey="Baleydier A" first="A" last="Baleydier">A. Baleydier</name><name sortKey="Benhamou, M" sort="Benhamou, M" uniqKey="Benhamou M" first="M" last="Benhamou">M. Benhamou</name><name sortKey="Benhamou, M" sort="Benhamou, M" uniqKey="Benhamou M" first="M" last="Benhamou">M. Benhamou</name><name sortKey="Breban, M" sort="Breban, M" uniqKey="Breban M" first="M" last="Breban">M. Breban</name><name sortKey="Breban, M" sort="Breban, M" uniqKey="Breban M" first="M" last="Breban">M. Breban</name><name sortKey="Dougados, M" sort="Dougados, M" uniqKey="Dougados M" first="M" last="Dougados">M. Dougados</name><name sortKey="Dougados, M" sort="Dougados, M" uniqKey="Dougados M" first="M" last="Dougados">M. Dougados</name><name sortKey="Fautrel, B" sort="Fautrel, B" uniqKey="Fautrel B" first="B" last="Fautrel">B. Fautrel</name><name sortKey="Lenoir, C" sort="Lenoir, C" uniqKey="Lenoir C" first="C" last="Lenoir">C. Lenoir</name><name sortKey="Ravaud, P" sort="Ravaud, P" uniqKey="Ravaud P" first="P" last="Ravaud">P. Ravaud</name><name sortKey="Ravaud, P" sort="Ravaud, P" uniqKey="Ravaud P" first="P" last="Ravaud">P. Ravaud</name><name sortKey="Ravaud, P" sort="Ravaud, P" uniqKey="Ravaud P" first="P" last="Ravaud">P. Ravaud</name><name sortKey="Roy, C" sort="Roy, C" uniqKey="Roy C" first="C" last="Roy">C. Roy</name><name sortKey="Roy, C" sort="Roy, C" uniqKey="Roy C" first="C" last="Roy">C. Roy</name><name sortKey="Trape, G" sort="Trape, G" uniqKey="Trape G" first="G" last="Trape">G. Trape</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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