Cost-Effectiveness of Biosimilars vs Leflunomide in Patients With Rheumatoid Arthritis
Authors' conclusion
In this economic evaluation study, the treatment sequences initiated with biosimilar DMARDs were cost-effective compared with the treatment sequence initiated with leflunomide in managing patients with RA who experienced failure with the initial methotrexate treatment.
Study context
- Population
- Patients with rheumatoid arthritis (RA) with inadequate response to MTX; RA patients diagnosed 2000–2021 from local electronic medical records, Hong Kong public institution19,469 [72.7%] women
- Participants
- 25,099 patients
- Exposure
- Treatment sequences initiated with biosimilar infliximab (CT-P13) or biosimilar adalimumab (ABP-501) vs leflunomide, all with MTX, after MTX failure
- Outcome
- Lifetime health care cost and QALYs of the simulated cohort
- Follow-up
- Lifetime
Methodological detailscost-effectiveness analysis, Markov disease transition model, lifetime horizon, scenario and sensitivity analyses, model inputs from retrospective electronic medical records, Monetary value in 2022; statistical analysis January 2023 to March 2024
- Cost-effectiveness analysis
- Markov disease transition model
- Lifetime horizon
- Scenario and sensitivity analyses
- Model inputs from retrospective electronic medical records
- Monetary value in 2022; statistical analysis January 2023 to March 2024
Main finding
As reported in the abstract
| Group | Value | Quality-adjusted life-years (QALYs) |
|---|---|---|
| Leflunomide | US $154 632 | 14.82 |
| Biosimilar infliximab | US $152 326 | 15.35 |
| Biosimilar adalimumab | US $145 419 | 15.55 |
Value
LeflunomideUS $154 632
Biosimilar infliximabUS $152 326
Biosimilar adalimumabUS $145 419
Quality-adjusted life-years (QALYs)
Leflunomide14.82
Biosimilar infliximab15.35
Biosimilar adalimumab15.55
Observational data: associations, not effects.
Further findings
Probability of being cost-effective, probabilistic sensitivity analysis (10 000 iterations)
ICER (US$/QALY) vs leflunomide, deterministic sensitivity analysis
- Biosimilar infliximab vs leflunomide, ICER range
- −15 797 to −8615
- Biosimilar adalimumab vs leflunomide, ICER range
- −9088 to 10 238
- All below the predefined willingness-to-pay threshold (US $48 555/QALY gain)
Original publication
Cost-Effectiveness of Biosimilars vs Leflunomide in Patients With Rheumatoid Arthritis. JAMA Netw Open. Published 3 June 2024. doi:10.
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