IDEAS home Printed from https://ideas.repec.org/a/spr/eujhec/v21y2020i1d10.1007_s10198-019-01110-w.html
   My bibliography  Save this article

The value of persistence in treatment with subcutaneous TNF-alpha inhibitors for ankylosing spondylitis

Author

Listed:
  • Axel Svedbom

    (ICON Clinical Research)

  • Johan Dalén

    (ICON Clinical Research)

  • Moa Ivergård

    (ICON Clinical Research)

  • Rebekah H. Borse

    (Merck & Co., Inc.)

  • Christopher M. Black

    (Merck & Co., Inc.)

  • Karin Luttropp

    (ICON Clinical Research)

  • Sumesh Kachroo

    (Merck & Co., Inc.)

Abstract

Objective To estimate the impact of persistence on cost-effectiveness of subcutaneous tumor necrosis factor-α inhibitors (SC-TNFis) from healthcare and societal perspectives in a United Kingdom ankylosing spondylitis (AS) population using a recently published Markov cohort model. Methods A recently published cost-effectiveness model developed for a National Institute for health and Care Excellence appraisal was extended to fit the current study; in brief, it is a Markov cohort model where treatment responders continue from the trial period with maintenance SC-TNFi treatment, while non-responders transition to conventional care. Costs and effects were modeled for a hypothetical SC-TNFi with average efficacy and price. Model outcomes included quality-adjusted life-years (QALYs), total direct and indirect lifetime costs, and incremental cost-effectiveness ratios (ICERs). The cost-effectiveness of SC-TNFi persistence was estimated by decreasing the annual discontinuation probability in five percentage point increments from 25 to 5% per annum. Results From a health care perspective, the ICERs for the modeled discontinuation rates compared to the baseline annual discontinuation rate (25%) ranged between GBP 17,277 and GBP 18,161. From a societal perspective, increased discontinuation rates resulted in decreased total costs and higher QALYs; hence, lower discontinuation rates dominated higher discontinuation rates from a societal perspective. Conclusion In conclusion, this study shows that, all else equal, higher SC-TNFi treatment persistence in AS is cost effective from a health care perspective and dominant from a societal perspective. Hence, all else equal, prescribing the SC-TNFi with the highest persistence may be considered a cost-effective strategy.

Suggested Citation

  • Axel Svedbom & Johan Dalén & Moa Ivergård & Rebekah H. Borse & Christopher M. Black & Karin Luttropp & Sumesh Kachroo, 2020. "The value of persistence in treatment with subcutaneous TNF-alpha inhibitors for ankylosing spondylitis," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(1), pages 45-54, February.
    • Handle: RePEc:spr:eujhec:v:21:y:2020:i:1:d:10.1007_s10198-019-01110-w
    DOI: 10.1007/s10198-019-01110-w
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1007/s10198-019-01110-w
    File Function: Abstract
    Download Restriction: Access to the full text of the articles in this series is restricted.
    File URL: https://libkey.io/10.1007/s10198-019-01110-w?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Roxanne Cooksey & Muhammad J Husain & Sinead Brophy & Helen Davies & Muhammad A Rahman & Mark D Atkinson & Ceri J Phillips & Stefan Siebert, 2015. "The Cost of Ankylosing Spondylitis in the UK Using Linked Routine and Patient-Reported Survey Data," PLOS ONE, Public Library of Science, vol. 10(7), pages 1-17, July.
    2. Koopmanschap, Marc A. & Rutten, Frans F. H. & van Ineveld, B. Martin & van Roijen, Leona, 1995. "The friction cost method for measuring indirect costs of disease," Journal of Health Economics, Elsevier, vol. 14(2), pages 171-189, June.
    3. Drummond, Michael F. & Sculpher, Mark J. & Claxton, Karl & Stoddart, Greg L. & Torrance, George W., 2015. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 4, number 9780199665884.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Klas Kellerborg & Werner Brouwer & Pieter Baal, 2020. "Costs and benefits of interventions aimed at major infectious disease threats: lessons from the literature," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(9), pages 1329-1350, December.
    2. Ina Rissanen & Leena Ala-Mursula & Iiro Nerg & Marko Korhonen, 2021. "Adjusted productivity costs of stroke by human capital and friction cost methods: a Northern Finland Birth Cohort 1966 study," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(4), pages 531-545, June.
    3. Hansen, Kristian S. & Moreno-Ternero, Juan D. & Østerdal, Lars P., 2024. "Quality- and productivity-adjusted life years: From QALYs to PALYs and beyond," Journal of Health Economics, Elsevier, vol. 95(C).
    4. Hansen, Kristian S. & Moreno-Ternero, Juan D. & Østerdal, Lars P., 2023. "Productivity and quality-adjusted life years: QALYs, PALYs and beyond," Working Papers 11-2023, Copenhagen Business School, Department of Economics.
    5. Pascal Crépey & Esther Redondo & Javier Díez-Domingo & Raúl Ortiz de Lejarazu & Federico Martinón-Torres & Ángel Gil de Miguel & Juan Luis López-Belmonte & Fabián P Alvarez & Hélène Bricout & Míriam S, 2020. "From trivalent to quadrivalent influenza vaccines: Public health and economic burden for different immunization strategies in Spain," PLOS ONE, Public Library of Science, vol. 15(5), pages 1-19, May.
    6. Erik Landfeldt & Niklas Zethraeus & Peter Lindgren, 2019. "Standardized Questionnaire for the Measurement, Valuation, and Estimation of Costs of Informal Care Based on the Opportunity Cost and Proxy Good Method," Applied Health Economics and Health Policy, Springer, vol. 17(1), pages 15-24, February.
    7. Marco Hafner & Erez Yerushalmi & Fredrik L. Andersson & Teodor Burtea, 2023. "Partially different? The importance of general equilibrium in health economic evaluations: An application to nocturia," Health Economics, John Wiley & Sons, Ltd., vol. 32(3), pages 654-674, March.
    8. Gravelle, Hugh & Schroyen, Fred, 2020. "Optimal hospital payment rules under rationing by waiting," Journal of Health Economics, Elsevier, vol. 70(C).
    9. Carola Lingua & Giulia Crespi & Cristina Becchio & Stefano Paolo Corgnati, 2023. "Designing IAQ-Resilient Post-Pandemic Buildings," Sustainability, MDPI, vol. 15(3), pages 1-17, January.
    10. Jonas Steel & Lode Godderis & Jeroen Luyten, 2018. "Methodological Challenges in the Economic Evaluation of Occupational Health and Safety Programmes," IJERPH, MDPI, vol. 15(11), pages 1-12, November.
    11. Tim A Kanters & Clazien A M Bouwmans & Naomi van der Linden & Siok Swan Tan & Leona Hakkaart-van Roijen, 2017. "Update of the Dutch manual for costing studies in health care," PLOS ONE, Public Library of Science, vol. 12(11), pages 1-11, November.
    12. Versteegh, M.M. & Brouwer, W.B.F., 2016. "Patient and general public preferences for health states: A call to reconsider current guidelines," Social Science & Medicine, Elsevier, vol. 165(C), pages 66-74.
    13. Irina Pokhilenko & Luca M. M. Janssen & Aggie T. G. Paulus & Ruben M. W. A. Drost & William Hollingworth & Joanna C. Thorn & Sian Noble & Judit Simon & Claudia Fischer & Susanne Mayer & Luis Salvador-, 2023. "Development of an Instrument for the Assessment of Health-Related Multi-sectoral Resource Use in Europe: The PECUNIA RUM," Applied Health Economics and Health Policy, Springer, vol. 21(2), pages 155-166, March.
    14. Chiranjeev Sanyal & Don Husereau, 2020. "Systematic Review of Economic Evaluations of Services Provided by Community Pharmacists," Applied Health Economics and Health Policy, Springer, vol. 18(3), pages 375-392, June.
    15. Iris Arends & Ute Bültmann & Willem van Rhenen & Henk Groen & Jac J L van der Klink, 2013. "Economic Evaluation of a Problem Solving Intervention to Prevent Recurrent Sickness Absence in Workers with Common Mental Disorders," PLOS ONE, Public Library of Science, vol. 8(8), pages 1-1, August.
    16. Simon Wieser & Bruno Horisberger & Sara Schmidhauser & Claudia Eisenring & Urs Brügger & Andreas Ruckstuhl & Jürg Dietrich & Anne Mannion & Achim Elfering & Özgür Tamcan & Urs Müller, 2011. "Cost of low back pain in Switzerland in 2005," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 12(5), pages 455-467, October.
    17. Andrew J. Mirelman & Miqdad Asaria & Bryony Dawkins & Susan Griffin & Richard Cookson & Peter Berman, 2020. "Fairer Decisions, Better Health for All: Health Equity and Cost-Effectiveness Analysis," World Scientific Book Chapters, in: Paul Revill & Marc Suhrcke & Rodrigo Moreno-Serra & Mark Sculpher (ed.), Global Health Economics Shaping Health Policy in Low- and Middle-Income Countries, chapter 4, pages 99-132, World Scientific Publishing Co. Pte. Ltd..
    18. Christopher M Doran & Irina Kinchin, 2020. "Economic and epidemiological impact of youth suicide in countries with the highest human development index," PLOS ONE, Public Library of Science, vol. 15(5), pages 1-11, May.
    19. Boniface Oyugi & Olena Nizalova & Sally Kendall & Stephen Peckham, 2024. "Does a free maternity policy in Kenya work? Impact and cost–benefit consideration based on demographic health survey data," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 25(1), pages 77-89, February.
    20. Muchandifunga Trust Muchadeyi & Karla Hernandez-Villafuerte & Gian Luca Tanna & Rachel D. Eckford & Yan Feng & Michela Meregaglia & Tessa Peasgood & Stavros Petrou & Jasper Ubels & Michael Schlander, 2024. "Quality Appraisal in Systematic Literature Reviews of Studies Eliciting Health State Utility Values: Conceptual Considerations," PharmacoEconomics, Springer, vol. 42(7), pages 767-782, July.

    More about this item

    Keywords

    Cost–benefit analysis; Medication persistence; Economic evaluation; Ankylosing spondylitis; Bechterew’s disease;
    All these keywords.

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:spr:eujhec:v:21:y:2020:i:1:d:10.1007_s10198-019-01110-w. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.