Valutazione economica del sistema di aferesi per la rimozione di granulociti e macrofagi (Adacolumn®) rispetto a biologico nel trattamento della colite ulcerosa moderata-severa in pazienti steroido-dipendenti o resistenti in Italia

Abstract

The treatment of chronic inflammatory bowel disease (IBD) is always a challenge for gastroenterologists dealing with this type of condition. The development of granulocyte-monocyte apheresis (GMA) appears to be an innovative approach, comprising both treatment safety and therapeutic potential. To assess the cost-consequence of granulocyte monocyte adsorption—apheresis (GMA-Apheresis; Adacolumn®) versus infliximab in the treatment of moderate-to-severe ulcerative colitis (UC) in steroid-dependent or steroid-resistant patients. One-year cost-consequence analysis from the Italian National Health Service (NHS) perspective using a decision tree model was carried out. Probabilities of each event were derived from literature and an expert panel. Direct medical costs were obtained from official sources (€2013). The average annual cost per patient who started the treatment with GMA-Apheresis was estimated to be €13,931.33; the cost was estimated to be €15,179.08, starting the treatment with infliximab. The sensitivity analysis confirmed the results of the base case. We performed a cost-consequence analysis focused on the use of GMA-Apheresis (Adacolumn®) in the therapeutic management of moderate-to-severe UC in steroid-dependent or steroid-resistant patients. From the Italian NHS perspective, GMA-Apheresis is a cost-saving strategy compared with infliximab.