PGI11 Cost per Responder and Remitter Analysis Comparing Ustekinumab to Comparator Treatments for Moderate-to-Severe Ulcerative Colitis in the United Kingdom

Abstract

The aim of this analysis was to compare the cost per responder (CPR) and remitter of ustekinumab versus all comparator treatments for ulcerative colitis (UC) (infliximab [IFX], IFX biosimilar, adalimumab [ADA], ADA biosimilar, vedolizumab [VEDO], golimumab [GOL], tofacitinib [TOFA]) in the United Kingdom. A CPR analysis was developed evaluating a hypothetical cohort of 1,000 patients with moderate-to-severe UC. Two populations were modelled: biologic-failure (BF) and non-biologic-failure (NBF). The model was developed from the payer perspective in the United Kingdom and set to a time horizon of one year. Treatment clinical efficacy was estimated through a network meta-analysis utilizing 1-year data from the pivotal trials of the comparator treatments (available for all comparators in the NBF population and only ADA and VEDO in the BF population). Resource use was based on the dosing schedules in the summary of product characteristics of each treatment. Acquisition and administration costs were derived from the British National Formulary, NHS national tariffs and PSSRU. In the NBF population, ustekinumab q12w demonstrated consistently lower cost/responder results (£17,729.53) compared to all comparator treatments in UC, with the exception of ADA biosimilar (£16,021.78), with cost/responder results ranging from £18,310.46 (ADA 40mg q2w) to £25,052.00 (VEDO 300mg q8w) in the NBF population. Ustekinumab q8w demonstrated lower cost/responder results (£24,514.85) than VEDO 300mg q4w (£41,943.80), GOL 100mg q4w (£33,820.41), and TOFA 10mg (£28,130.21) in the NBF population. In the BF population, ustekinumab q12w (£24,771.90) and q8w (£29,670.87) demonstrated lower cost/responder results than VEDO 300mg q8w (£33,800.60) and VEDO 300mg q4w (£52,635.86), respectively. The cost/remitter analysis demonstrated a similar trend to the cost/responder analysis in both the NBF and the BF populations. The use of ustekinumab for treatment of moderate-to-severe UC not only addresses an unmet medical need, but also provides efficient economic resource allocation in the United Kingdom.