P322 Cost per clinical outcomes with biologics for the treatment of moderately to severely active ulcerative colitis
J. Jansen1, R. Mody*2, I. Ursan2, M. Lorenzi1, H. Patel3, M. Alberton1
1Redwood Outcomes, , San Francisco, United States, 2Takeda Pharmaceuticals International, Inc., Global Outcomes Research, Deerfield, United States, 3Immensity Consulting, Inc, , Chicago, United States
To compare cost per clinical outcomes of vedolizumab (VDZ) with approved biologics over one year period for the treatment of anti-tumour necrosis factor (TNF) naïve and anti-TNF experienced patients with moderately to severely active ulcerative colitis (UC) from a UK perspective.
With a systematic literature search, currently available randomized controlled trials for approved biologics (infliximab [IFX], adalimumab [ADA], golimumab [GOL], and VDZ) for treatment of UC were identified. Outcomes of interest included response and remission defined according to the Mayo score as reported in the individual trials. Due to differences in study designs, recalculation of GOL and VDZ outcomes was done to ensure valid comparisons with ADA and IFX trials. The odds ratios for sustained response and remission at 52 weeks of biologic treatment relative to placebo were estimated using network meta-analyses and were transformed into number-needed-to-treat (NNT) using the average placebo Results across all trials. For the cost per outcomes analyses, we assumed that responders to induction treatment with ADA and VDZ continue with maintenance treatment at 8 and 10 weeks respectively, based on the respective labels. For IFX and GOL, we assumed that in the absence of response at respectively 8 and 6 weeks, treatment was discontinued in line with clinical trial design. The acquisition and administration costs for the biologics were calculated based on the labeled dose and frequency of administration.
The NNT and cost per patient with sustained response and remission at 52 weeks for anti-TNF naïve UC patients was estimated to be the lowest for VDZ followed by IFX, ADA and GOL (Table 1). For the anti-TNF experienced UC patients, the NNT for sustained response for VDZ and ADA was 4.0 (2.2; 9.7) and 13.3 (5.0; 82.2) respectively; and for sustained remission was 9.2 (4.1; 27.8) and 41.4 (11.7; 303.9) respectively. The cost per anti-TNF experienced UC patient with sustained response was £49,912 (95%CI 27,535; 122,364) with VDZ and £69,736 (95%CI 26,176; 431,971) with ADA; and the cost per patient with sustained remission was £116,100 (95%CI 51,233; 349,433) with VDZ and £217,457 (95%CI 61,237; 1,597,033) with ADA.
“Table 1 Number needed-to-treat and cost per clinical outcomes of biologics among anti-TNF naïve patients with UC”
VDZ had a lower NNT and cost per patient for sustained response and remission potentially providing better clinical and economic value compared to other biologics licensed for the treatment of patients with moderately to severely active UC.