Cost-effectiveness analysis of baricitinib versus adalimumab for the treatment of moderate-to-severe rheumatoid arthritis in Spain

Figures & data

Figure 1 Schematic representation of the model structure.

Abbreviations: ACR, American College of Rheumatology; HAQ, Health Assessment Questionnaire.

Table 1 ACR response rates at week 24 (RA-BEAM, modified intent-to-treat population)

ACR response category	Adalimumab (N=330) Rate (SE)	Baricitinib (N=487) Rate (SE)
≥ACR70	0.218 (0.023)	0.298 (0.021)
≥ACR50 to <ACR70	0.236 (0.023)	0.207 (0.018)
≥ACR20 to <ACR50	0.209 (0.022)	0.234 (0.019)
Less than ACR20	0.336 (0.026)	0.261 (0.020)

Notes: ACR response rates for each ACR band calculated from cumulative ACR response rates. From N Engl J Med, Taylor PC, Keystone EC, van der Heijde D, Weinblatt ME, Del Carmen Morales L, Reyes Gonzaga J, et al, Baricitinib versus placebo or adalimumab in rheumatoid arthritis., 376(7), 652-662. Copyright © 2017 Massachusetts Medical Society. Reprinted with permission from Massachusetts Medical Society.⁶

Abbreviation: ACR, American College of Rheumatology.

Table 2 Results of deterministic, probabilistic and sensitivity analyses

Results for the deterministic analysis
	Baricitinib	Adalimumab		Incremental		ICER
Cost breakdown (per patient)						Dominant
Drug acquisition costs	€59,122	€59,434		–€312
Monitoring costs	€17,285	€17,288		–€3
Hospitalization costs	€14,842	€15,084		–€243
Total costs	€91,249	€91,807		–€558
Clinical outcomes (per patient)
Quality-adjusted life years	8.429	8.339		0.090
Time on treatment (years)	3.66	3.34		0.32
Results for the probabilistic analysis
Treatment	Discounted costs	Discounted QALYs		ICER		Incremental Analysis
Adalimumab	€91,623	8.336		-
Baricitinib	€91,085	8.426		–€5,994		Dominant
Results for sensitivity analyses
Scenario			Incremental cost		Incremental QALYs	ICER
Price discount scenario 1: (baricitinib 30%, adalimumab 10%)			–€7,459		0.090	Dominant
Price discount scenario 2: (baricitinib 30%, adalimumab 20%)			–€4,030		0.090	Dominant
Price discount scenario 3: (baricitinib 30%, adalimumab 30%)			–€601		0.090	Dominant
Pricing discount scenario 4: (baricitinib 30%, adalimumab 40%)			€2,827		0.090	€31,368
Nonlinear HAQ progression on palliative care, Hernandez QoL mapping, Carlson 2015 HAQ improvement			–€546		0.091	Dominant
Nonlinear HAQ progression on palliative care, Malottki QoL mapping, RA-BEAM HAQ improvement			–€558		0.116	Dominant
Linear HAQ progression on palliative care, Hernandez QoL mapping, RA-BEAM HAQ improvement			–€767		0.141	Dominant
Discount rate for both costs and benefits =0%			–€589		0.101	Dominant
Discount rate for both costs and benefits =5%			–€548		0.084	Dominant
Time horizon =10 years			–€666		0.075	Dominant
Time horizon =20 years			–€537		0.092	Dominant
Inclusion of SAEs from RA-BEAM			€339		0.092	€3,692
HAQ change from baseline at week 24 from Carlson 2015			–€546		0.087	Dominant

Abbreviations: HAQ, Health Assessment Questionnaire; ICER, incremental cost-effectiveness ratio; QALY, quality-adjusted life year; QoL, quality of life; SAE, serious adverse events.

Figure 2 Cost–effectiveness plane and cost–effectiveness acceptability curve.

Abbreviation: QALY, quality-adjusted life year.

Taylor PC, Keystone EC, van der Heijde D, et al. Baricitinib versus Placebo or adalimumab in rheumatoid arthritis. N Engl J Med. 2017;376(7):652–662. doi:10.1056/NEJMoa160834528199814

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