PGI12 COST PER RESPONDER ANALYSIS EVALUATED THROUGH CLINICAL RESPONSE AND REMISSION RATE OF ADALIMUMAB, USTEKINUMAB AND VEDOLIZUMAB FOR THE TREATMENT OF CROHN'S DISEASE IN BIOLOGIC NAIVE PATIENTS FROM THE BRAZILIAN PRIVATE HEALTHCARE SYSTEM PERSPECTIVE

Abstract

The aim of this study is to compare cost per responder of adalimumab, ustekinumab and vedolizumab for the treatment of biologic naïve patients with Crohn’s disease (CD) from the Brazilian private payer perspective, evaluated through clinical response and remission rate. To compare adalimumab, ustekinumab and vedolizumab clinical outcomes, a published network metanalysis was accessed. Clinical response was evaluated through CD activity index reduction of 100 points (CDAI-100) and remission rate was evaluated through CD activity index score under 150 points (CDAI<150) in biologic naïve patients. Only drug acquisition costs were considered, which were obtained from official price magazine and calculated according to label. Cost per patient achieving clinical response and cost per remittent patient were calculated dividing the induction and maintenance year costs by the proportion of patients achieving CDAI-100 and CDAI<150, respectively. In the analysis with dose escalated clinical data, costs were calculated accordingly. For a three-years’ time horizon hypothetical scenario, clinical data was considered the same, but costs were calculated accordingly. Costs per biologic naïve patient achieving clinical response for adalimumab, ustekinumab and vedolizumab were: BRL377K, BRL404K and BRL452K in induction year; BRL327K, BRL250K and BRL367K considering maintenance year costs; and BRL625K, BRL372K and BRL712K in the dose escalation scenario. Cost per remitter patient for adalimumab, ustekinumab and vedolizumab were: BRL373K, BRL449K and BRL421K in induction year; BRL323K, BRL278K and BRL342K considering maintenance year costs; and BRL631K, BRL409K BRL670K in the dose escalation scenario. In the 3 years scenario analysis, ustekinumab presented the lowest cost per responder result for both outcomes. Adalimumab demonstrated slightly favorable cost per responder results in the induction year and ustekinumab demonstrated to have better cost per responder in scenarios of maintenance years, with dose escalation data and in three-years’s time horizon, for both clinical response and remission rate outcomes.