Cost-per-remission analysis of infliximab compared to adalimumab among adults with moderate-to-severe ulcerative colitis

Abstract

Objective:

To compare cost per remission (CPR) of infliximab (IFX) versus adalimumab (ADA) for the treatment of moderately-to-severely active UC.

Methods:

This is CPR model comparing IFX and ADA in the treatment of UC using clinical trial data. Clinical outcome measures include clinical remission and sustained clinical remission (SCR). Economic endpoints were modeled as medication costs. CPR ratios and number needed to treat (NNT) costs were computed at 8, 52, and 54 weeks.

Results:

CPR for bio-naïve patients for IFX and ADA at weeks 8, 52, and 54 was $42,086 vs. $79,558: $147,379 vs. $320,097; $147,379 vs. $330,767, respectively. CPR for all patients for IFX and ADA at weeks 8, 52, and 54 was $42,086 vs. $113,812; $147,379 vs. $349,197; $147,379 vs. $360,836, respectively. Cost per SCR for bio-naïve patients and all patients for IFX and ADA was $203,205 vs. $682,873 and $203,205 vs. $698,393, respectively. NNT and NNT costs for clinical remission for bio-naïve patients at weeks 8, 52, and 54 were lower for IFX (4 vs.10, $40,235 vs. $81,945; 5 vs.10, $134,115 vs. $307,293; 5 vs. 10, $134,115 vs. $317,536, respectively) than for ADA. NNT and NNT costs for clinical remission for all patients at weeks 8, 52, and 54 were lower for IFX (4 vs.14, $40,235 vs. $114,723; 5 vs.11, $134,115 vs. $338,022; 5 vs. 11, $134,115 vs. $349,290, respectively) than for ADA. NNT and NNT costs for SCR for bio-naïve and all patients were lower for IFX (8 vs. 22, $214,584 vs. $676,045; 8 vs.23, $214,584 vs. $706,774) than for ADA. Study limitations include lack of head-to-head trial data, different primary endpoints between the two clinical trials, and indirect costs were not included.

Conclusion:

IFX had lower CPR and cost per SCR than ADA in the treatment of moderately to severely active UC.

Keywords::

• Health economics
• Anti-TNF
• Ulcertive colitis
• Cost effectiveness

Transparency

Declaration of funding

This study was sponsored by Janssen Scientific Affairs, Inc.

Declaration of financial/other relationships

J.H.L. is an employee of Janssen Scientific Affairs, Inc. Her role included the study concept, study methodology, data analyses, manuscript preparation, manuscript writing, and manuscript finalization.

P.J.M. is an employee of Statistical Solutions which is a paid consultant to Janssen Scientific Affairs, LLC. J.A.R. is a paid consultant to Statistical Solutions which is a paid for consultancy by Janssen Scientific Affairs, LLC.

Acknowledgments

We would like to thank Rolli Greer and Dr. Divyesh Khetia for their review of the manuscript. Mr. Greer is an employee of Janssen Biotech, Inc. Dr. Khetia is an employee of Janssen Scientific Affairs, LLC.