Key considerations for modelling the long-term costs and benefits of treatments for ANCA-associated vasculitis.
Clin Exp Rheumatol
; 42(4): 782-785, 2024 Apr.
Article
en En
| MEDLINE
| ID: mdl-38526008
ABSTRACT
OBJECTIVES:
Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a group of severe and chronic autoimmune diseases. Patients undergo two treatment phases inducing remission and maintaining remission to prevent organ damage. Immunosuppressants, including glucocorticoids (GCs) are used as first-line treatment, but long-term GC use is associated with toxic effects. Novel treatments reduce or replace the need for long-term GC, and therefore can reduce GC-related toxicity. The evolving treatment landscape has presented new challenges for health technology assessment (HTA) of new treatments in AAV and long-term modelling of costs and outcomes in this disease.METHODS:
Using the appraisal of avacopan in England (NICE) as a case study, this paper aims to identify the key challenges involved in the economic evaluation of new treatments for AAV, with a particular focus on the long-term modelling of the treatment costs and benefits for the purpose of HTA. The outcome of this study is a set of recommendations for modelling the cost-effectiveness of new treatments for AAV from the HTA perspective.RESULTS:
The discussion focuses on the appropriate model structure, approach to modelling end-stage renal disease (ESRD) as a key determinant of costeffectiveness, capturing the impact of GC-related adverse events, and estimation of short and long-term costs of AAV.CONCLUSIONS:
Economic evaluation of new treatments for AAV needs to capture all relevant downstream effects. ESRD is a key driver of cost-effectiveness but is associated with major uncertainty. Future observational studies need to offer sufficient detail to allow for differentiation in event rates across treatment options.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Costos de los Medicamentos
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Análisis Costo-Beneficio
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Modelos Económicos
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Vasculitis Asociada a Anticuerpos Citoplasmáticos Antineutrófilos
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Inmunosupresores
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Compuestos de Anilina
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Ácidos Nipecóticos
Límite:
Humans
Idioma:
En
Revista:
Clin Exp Rheumatol
Año:
2024
Tipo del documento:
Article