Cost per Number Needed to Treat (NNT) for upadacitinib in the treatment of bio-exposed patients with moderately-severely active ulcerative rectocolitis

Authors

  • Flavio Caprioli Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milano - Italy Gastroenterology and Endoscopy Unit, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico di Milano, Milano - Italy
  • Massimo Claudio Fantini epartment of Medical Science and Public Health, University of Cagliari, Cagliari - Italy Azienda Ospedaliero-Universitaria (AOU) di Cagliari, Cagliari - Italy https://orcid.org/0000-0003-2870-3827
  • Francesca Marando AbbVie, Roma - Italy
  • Dario Scaduto AbbVie, Roma - Italy https://orcid.org/0009-0004-8863-0249
  • Roberto Ravasio HEOR and RWE Lead, PharmaLex Italy S.p.A. formerly MA Provider, Milano - Italy https://orcid.org/0000-0002-5477-1957

DOI:

https://doi.org/10.33393/grhta.2024.2658

Keywords:

Bio-exposed, Cost per NNT, Italian NHS, Ulcerative Rectocolitis, Upadacitinib

Abstract

Background: Only limited information is available on cost efficacy of the advanced therapies for the treatment of ulcerative rectocolitis. We evaluated the efficacy and the treatment costs of these advanced therapies in the treatment of bio-exposed (primary failure to a biological agent) patients with moderately to severely active ulcerative rectocolitis.

Methods: Data from a previous network meta-analysis (NMA) in the treatment of bio-exposed patients with moderately to severely active ulcerative rectocolitis was used. The analysis involved three therapies approved in Italy for the treatment of moderately to severely active ulcerative rectocolitis: upadacitinib (UPA), ustekinumab (UST) and vedolizumab (VDZ). According to the NMA results, the analysis was conducted considering two different timepoints: induction and maintenance. The pharmacoeconomic comparison between advanced therapies was carried out to estimate the respective cost for the NNT (Number Needed to Treat) compared to placebo using the clinical response (CRes) for the induction and clinical remission (CRem) and endoscopic improvement (EI) for the maintenance. Only the ex-factory price of each advanced therapy was considered. The cost per NNT was adopted as a cost-effectiveness indicator.

Results: Independently of the timepoint considered (induction or maintenance) and the clinical (CRem and CRes) or endoscopic endpoint (EI) evaluated, UPA had always the lower cost per NNT than UST and VDZ. For example, considering the induction and the CRes, the cost per NNT for upadacitinib (45 mg) was € 7,862.07 compared to € 30,459.38 for ustekinumab (6 mg/kg) and to € 67,868.00 for vedolizumab.

Conclusion: Upadacitinib is a cost-effective therapeutic option compared to ustekinumab and vedolizumab in the treatment of bio-exposed patients with moderately to severely active ulcerative rectocolitis.

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Published

2024-03-07

How to Cite

Caprioli, F., Fantini, M. C., Marando, F., Scaduto, D., & Ravasio, R. (2024). Cost per Number Needed to Treat (NNT) for upadacitinib in the treatment of bio-exposed patients with moderately-severely active ulcerative rectocolitis. Global and Regional Health Technology Assessment, 11(1), 55–67. https://doi.org/10.33393/grhta.2024.2658

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Original Research Articles

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Received 2023-09-08
Accepted 2024-02-14
Published 2024-03-07

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