Immunotherapy · 2024
Cost-effectiveness of Upadacitinib vs. Tofacitinib for moderate-to-severe rheumatoid arthritis in China.
СтатьяСравнительное исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Xu Xinyi, Geng Linyu, Xu Xue, Huang Saisai, Liang Jun
Аннотация
BACKGROUND: Patients with moderate-to-severe rheumatoid arthritis (RA) in China experience multi-system dysfunction, resulting in a substantial economic burden. This study aimed to compare the cost-effectiveness of Upadacitinib and Tofacitinib as treatment options for moderate-to-severe RA patients in China.
MATERIALS AND METHODS: A Decision Tree-Markov model with a 24-week cycle was constructed, simulating health status transitions based on the tsDMARDs-TNFi-PC clinical pathway. The analysis included the calculation of treatment costs (yuan) and QALYs (quality-adjusted life-years) for the Upadacitinib and Tofacitinib groups. Cost-effectiveness was evaluated using the incremental cost-effectiveness ratio (ICER) and compared against a willingness-to-pay (WTP) threshold. One-way sensitivity analysis and probabilistic sensitivity analysis (PSA) were conducted to verify the robustness of the results.
RESULTS: Compared with Tofacitinib, the Upadacitinib group incurred an additional cost of 1,375 yuan per patient, with an incremental gain of 0.17 QALYs. The ICER was 7,880.38 yuan/QALY, which is well below the WTP threshold of 1.5 times China's GDP per capita, indicating favorable cost-effectiveness.
CONCLUSIONS: In the context of China's healthcare system, Upadacitinib represents a cost-effective long-term first-line treatment option for moderate-to-severe RA patients.
MATERIALS AND METHODS: A Decision Tree-Markov model with a 24-week cycle was constructed, simulating health status transitions based on the tsDMARDs-TNFi-PC clinical pathway. The analysis included the calculation of treatment costs (yuan) and QALYs (quality-adjusted life-years) for the Upadacitinib and Tofacitinib groups. Cost-effectiveness was evaluated using the incremental cost-effectiveness ratio (ICER) and compared against a willingness-to-pay (WTP) threshold. One-way sensitivity analysis and probabilistic sensitivity analysis (PSA) were conducted to verify the robustness of the results.
RESULTS: Compared with Tofacitinib, the Upadacitinib group incurred an additional cost of 1,375 yuan per patient, with an incremental gain of 0.17 QALYs. The ICER was 7,880.38 yuan/QALY, which is well below the WTP threshold of 1.5 times China's GDP per capita, indicating favorable cost-effectiveness.
CONCLUSIONS: In the context of China's healthcare system, Upadacitinib represents a cost-effective long-term first-line treatment option for moderate-to-severe RA patients.