PGI9 Cost-Effectiveness Comparison of Vedolizumab, Infliximab and Conventional Therapy for the Treatment of Biologic-Naïve, Moderately to Severely ACTIVE Ulcerative Colitis Patients in China

Abstract

To evaluate the relative cost-effectiveness of vedolizumab (VDZ), infliximab (IFX) and conventional therapy (CVT) for treating moderately to severely active Ulcerative Colitis (UC) patients who are naïve to biologic treatments. A Markov decision model was developed to compare VDZ, IFX and CVT, currently approved in China for moderately to severely active UC patients who are biologic-naive. The evaluation was performed using a healthcare system perspective covering the life-time horizon (30 years) for a patient. Efficacy data were derived from a network meta-analysis of published clinical trial data. Utility 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. A one-way sensitivity analyses and a multivariate probabilistic sensitivity analyses were conducted. A patient treated with VDZ, IFX and CVT accrued 11.8, 11.5 and 10.4 QALYs respectively in the 30-year simulation. Total direct medical costs for an average patient were RMB 1.573 Million for VDZ, RMB 1.560 Million for IFX and RMB 1.714 Million for CVT in the same period. The ICER for VDZ vs IFX was RMB 46,389/QALY while VDZ dominated CVT with lower cost and better outcome. In the comparison vs CVT, VDZ higher acquisition cost was offset by its lowest non-pharmacological medical costs among the three interventions. Sensitivity analysis confirmed results were stable to random parameter value fluctuations. The cost-effective analysis showed that VDZ was dominant over CVT treatment. VDZ was also cost-effective versus IFX, based on China’s 2019 per capita GDP of RMB 70,892. VDZ may provide the best value for money in treating biologic-naïve patients with moderately to severely active Ulcerative Colitis in China.