Cost-Effectiveness Analysis of Adalimumab Versus Cyclosporine for Vogt-Koyanagi-Harada Disease: A Randomized Controlled Study.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Accounts of Chemical Research Pub Date : 2024-10-01 Epub Date: 2024-05-23 DOI:10.1080/02713683.2024.2355659

Lingyu Dai, Zhenyu Zhong, Qiuying Wu, Yu Gao, Xiaorong Lu, Fuxiang Zhang, Chong Tang, Yao Wang, Chunjiang Zhou, Peizeng Yang

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Abstract

Purpose: To compare the 26-week cost-effectiveness of adalimumab-corticosteroids (ADA-CS) and cyclosporine-corticosteroids (CSA-CS) for Vogt-Koyanagi-Harada (VKH).

Methods: A preplanned cost-effectiveness analysis based on the per-protocol population of a randomized-controlled trial. VKH subjects were randomized to receive either cyclosporine (100-200 mg daily) combined with corticosteroids or adalimumab (40 mg twice monthly) combined with corticosteroids. The primary outcome of this cost-effectiveness study was the incremental cost-effectiveness ratio (ICER). Costs and quality-adjusted life-years (QALYs) data were calculated by the medical records and health utility, respectively. Subgroup (early and late-phase VKH) analysis and sensitivity analyses were performed.

Results: The ICER at 26 weeks was $62,425/QALY for the total participants. Compared to the CSA-CS group, costs in the ADA-CS group were more expensive (mean difference [ΔA-C]: $2,497) with more gains in QALYs (mean difference [ΔA-C]: 0.04). The probability of ADA-CS being cost-effective was 0.17 and 0.41 at willingness to pay (WTP) thresholds of $12,000/QALY and $36,000/QALY, respectively. Subgroup analysis and sensitivity analyses showed consistent findings with the primary analysis.

Conclusions: Regardless of early or late-phase VKH, the CSA-CS strategy may be recommended as the preferred initial choice for the majority of VKH.

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阿达木单抗与环孢素治疗Vogt-Koyanagi-Harada病的成本效益分析：随机对照研究

目的：比较阿达木单抗-皮质类固醇（ADA-CS）和环孢素-皮质类固醇（CSA-CS）治疗Vogt-Koyanagi-Harada（VKH）26周的成本效益：方法：根据随机对照试验的按方案人群进行预先计划的成本效益分析。VKH受试者被随机分配接受环孢素（每天100-200毫克）联合皮质类固醇激素或阿达木单抗（每月两次，每次40毫克）联合皮质类固醇激素治疗。这项成本效益研究的主要结果是增量成本效益比（ICER）。成本和质量调整生命年（QALYs）数据分别由医疗记录和健康效用计算得出。进行了亚组（早期和晚期 VKH）分析和敏感性分析：所有参与者在 26 周时的 ICER 为 62,425 美元/QALY。与 CSA-CS 组相比，ADA-CS 组的成本更昂贵（平均差异[ΔA-C]：2,497 美元），但 QALYs 收益更高（平均差异[ΔA-C]：0.04）。在支付意愿（WTP）阈值为 12,000 美元/QALY 和 36,000 美元/QALY 时，ADA-CS 具有成本效益的概率分别为 0.17 和 0.41。分组分析和敏感性分析结果与主要分析结果一致：无论 VKH 是早期还是晚期，CSA-CS 策略均可作为大多数 VKH 的首选初始方案。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.