Cost-effectiveness of Upadacitinib vs. Tofacitinib for moderate-to-severe rheumatoid arthritis in China.

IF 2.7 4区医学 Q3 IMMUNOLOGY Immunotherapy Pub Date : 2024-11-17 DOI:10.1080/1750743X.2024.2426972

Xinyi Xu, Linyu Geng, Xue Xu, Saisai Huang, Jun Liang

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Abstract

Background: Patients with moderate-to-severe rheumatoid arthritis (RA) in China experience multi-system dysfunction, resulting in a substantial economic burden. This study aimed to compare the cost-effectiveness of Upadacitinib and Tofacitinib as treatment options for moderate-to-severe RA patients in China.

Materials and methods: A Decision Tree-Markov model with a 24-week cycle was constructed, simulating health status transitions based on the tsDMARDs-TNFi-PC clinical pathway. The analysis included the calculation of treatment costs (yuan) and QALYs (quality-adjusted life-years) for the Upadacitinib and Tofacitinib groups. Cost-effectiveness was evaluated using the incremental cost-effectiveness ratio (ICER) and compared against a willingness-to-pay (WTP) threshold. One-way sensitivity analysis and probabilistic sensitivity analysis (PSA) were conducted to verify the robustness of the results.

Results: Compared with Tofacitinib, the Upadacitinib group incurred an additional cost of 1,375 yuan per patient, with an incremental gain of 0.17 QALYs. The ICER was 7,880.38 yuan/QALY, which is well below the WTP threshold of 1.5 times China's GDP per capita, indicating favorable cost-effectiveness.

Conclusions: In the context of China's healthcare system, Upadacitinib represents a cost-effective long-term first-line treatment option for moderate-to-severe RA patients.

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中国中重度类风湿性关节炎患者服用乌达替尼与托法替尼的成本效益对比。

背景：中国的中重度类风湿性关节炎（RA）患者会出现多系统功能障碍，造成巨大的经济负担。本研究旨在比较乌达替尼和托法替尼作为中国中重度类风湿关节炎患者治疗方案的成本效益：构建了一个以24周为周期的决策树-马尔科夫模型，模拟了基于tsDMARDs-TNFi-PC临床路径的健康状况转换。分析包括计算Upadacitinib组和Tofacitinib组的治疗成本（人民币）和QALYs（质量调整生命年）。成本效益采用增量成本效益比（ICER）进行评估，并与支付意愿（WTP）阈值进行比较。为了验证结果的稳健性，还进行了单向敏感性分析和概率敏感性分析（PSA）：与托法替尼相比，乌帕他替尼组每名患者的额外费用为1,375元，增量收益为0.17 QALYs。ICER为7880.38元/QALY，远低于中国人均GDP的1.5倍的WTP阈值，表明成本效益良好：结论：在中国的医疗体系中，对于中重度RA患者而言，乌达替尼是一种具有成本效益的长期一线治疗方案。

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

Immunotherapy 医学-免疫学

CiteScore

5.00

自引率

3.60%

发文量

113

审稿时长

6-12 weeks

期刊介绍： Many aspects of the immune system and mechanisms of immunomodulatory therapies remain to be elucidated in order to exploit fully the emerging opportunities. Those involved in the research and clinical applications of immunotherapy are challenged by the huge and intricate volumes of knowledge arising from this fast-evolving field. The journal Immunotherapy offers the scientific community an interdisciplinary forum, providing them with information on the most recent advances of various aspects of immunotherapies, in a concise format to aid navigation of this complex field. Immunotherapy delivers essential information in concise, at-a-glance article formats. Key advances in the field are reported and analyzed by international experts, providing an authoritative but accessible forum for this vitally important area of research. Unsolicited article proposals are welcomed and authors are required to comply fully with the journal''s Disclosure & Conflict of Interest Policy as well as major publishing guidelines, including ICMJE and GPP3.