Budesonide with multi-matrix technology as second-line treatment for ulcerative colitis: evaluation of long-term cost-effectiveness in the Netherlands
| العنوان: | Budesonide with multi-matrix technology as second-line treatment for ulcerative colitis: evaluation of long-term cost-effectiveness in the Netherlands |
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| المؤلفون: | Alexandre Gherardi, Yum Lina Yip Sonderegger, Ola Ghatnekar, Johan Kuijvenhoven, Stéphane Roze |
| المصدر: | Journal of Medical Economics. 21:869-877 |
| بيانات النشر: | Informa UK Limited, 2018. |
| سنة النشر: | 2018 |
| مصطلحات موضوعية: | Adult, Male, Budesonide, medicine.medical_specialty, medicine.drug_class, Cost effectiveness, Cost-Benefit Analysis, Prednisolone, Anti-Inflammatory Agents, Severity of Illness Index, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, Netherlands, Second line treatment, business.industry, Health Policy, Remission Induction, Health Services, Middle Aged, medicine.disease, Ulcerative colitis, Markov Chains, Hospitalization, 030220 oncology & carcinogenesis, Health Resources, Corticosteroid, Colitis, Ulcerative, Female, 030211 gastroenterology & hepatology, Quality-Adjusted Life Years, business, Models, Econometric, MMX, medicine.drug |
| الوصف: | Budesonide with multi-matrix technology (MMX) is an oral corticosteroid, shown to have high topical activity against ulcerative colitis (UC) while maintaining low systemic bioavailability with few adverse events. The aim of this study was to evaluate the cost-effectiveness of budesonide MMX versus commonly used corticosteroids, in the second-line treatment of active mild-to-moderate UC in the Netherlands.An eight-state Markov model with an 8 week cycle length captured remission, four distinct therapy stages, hospitalization, possible colectomy and mortality. Remission probability for budesonide MMX was based on the CORE-II study. Population characteristics were derived from the Dutch Inflammatory Bowel Disease South Limburg cohort (n = 598) and included patients with proctitis (39%), left-sided (42%) and extensive disease (19%). Comparators (topical budesonide foam and enema, oral budesonide and prednisolone) were selected based on current Dutch clinical practice. Treatment effects were evaluated by network meta-analysis using a Bayesian framework. Cost-effectiveness analysis was performed over a 5 year time horizon from a societal perspective, with costs, health-state and adverse event utilities derived from published sources. Outcomes were weighted by disease extent distribution and corresponding comparators.Budesonide MMX was associated with comparable quality-adjusted life year (QALY) gain versus foam and oral formulations (+0.01 QALYs) in the total UC population, whilst being cost-saving (EUR 366 per patient). Probabilistic sensitivity analysis evaluated an 86.6% probability of budesonide MMX being dominant (cost-saving with QALY gain) versus these comparators. Exploratory analysis showed similar findings versus prednisolone.Differing definitions of trial end-points and remission across trials meant indirect comparison was not ideal. However, in the absence of head-to-head clinical data, these comparisons are reasonable alternatives and currently offer the only comparison of second-line UC treatments.In the present analysis, budesonide MMX was shown to be cost-effective versus comparators in the total UC population, for the second-line treatment of active mild-to-moderate UC in the Netherlands. |
| تدمد: | 1941-837X 1369-6998 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::354965d88c36cecfbd786582f6589a88 https://doi.org/10.1080/13696998.2018.1484371 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....354965d88c36cecfbd786582f6589a88 |
| قاعدة البيانات: | OpenAIRE |
PDF full text from Publisher | تدمد: | 1941837X 13696998 |
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