PGI8 Cost Utility Analysis of Vedolizumab Versus Conventional Therapy for Biologic-Naïve, Moderately to Severely ACTIVE Crohn's Disease Patients in China

Abstract

To assess the cost-effectiveness of vedolizumab (VDZ) intravenous (IV) therapy vs. conventional therapy (CVT) in the treatment of patients with moderately to severely active Crohn’s disease (CD) who are naïve to biologic therapies. A Markov simulation model was developed to compare VDZ with CVT for the treatment of biologic-naïve, moderately to severely active CD patients in China. CVT was selected as the comparator because it is the most widely prescribed pharmacological treatment for CD in China. CVT includes well known drugs such as 5-ASA, systemic or topical corticosteroids, and immunosuppressants. The analysis took the healthcare system perspective covering the patients’ life-time horizon (30 years). Population characteristics and efficacy data were derived from published clinical trial data (GEMINI 2). Utilities scores, surgery risks, and mortality information were obtained from a targeted literature review. Costs (China renminbi [RMB]) and outcomes (measured in Quality-Adjusted Life-Years [QALY]) were calculated and discounted at the annualized rate of 3.5%. The Incremental Cost Effectiveness Ratio (ICER) was estimated to support cost effectiveness determination. One-way sensitivity analyses and probabilistic sensitivity analyses were also performed. VDZ patients and CVT patients accrued 10.86 and 9.46 QALYs respectively in the lifetime simulation. Total direct medical costs for an average VDZ patient vs. CVT patient were RMB 1.77 Million vs RMB 1.93 Million. VDZ dominated CVT as VDZ patients accumulated more QALYs at a lower cost. The time spent in the remission state in the VDZ arm was more than double compared to CVT, while the time spent in the surgery state was reduced by 20% compared to CVT. Sensitivity analysis confirmed results were stable to random parameter value fluctuations. VDZ may be a dominant strategy to CVT in biologic-naive patients with moderately to severely active CD in China.