RESUMO
OBJECTIVES: Assess the efficiency of biologic treatment for moderate to severe ulcerative colitis (UC) which are indicated and financed for this pathology by Spain. METHODS: A Markov model was constructed to simulate the progression in a cohort of patients with moderate to severe UC. The perspective chosen was National Health Service with an over 10 years of time horizon, with a discount rate of 3%, and established threshold of 30,000/quality-adjusted life-year (QALY). RESULTS: The comparison between infliximab versus adalimumab achieved an incremental cost-effectiveness ratio (ICER) of 45,582/QALY, with a 0.900 QALYs difference of efficacy and an incremental cost of 41,036. Golimumab versus adalimumab reached an ICER of 2,175,992/QALY, with a difference of 0.001 QALY in efficacy and a raising cost to 2,611. The comparison between vedolizumab with adalimumab achieved an ICER of 90,532/QALY, 0.930 QALYs of difference and an increasing cost of 84,218. The probabilistic sensitivity analysis shows that adalimumab would be cost-effective in the 65.2% of the simulations, infliximab in the 18.4%, golimumab in the 16.4% and vedulizumab for the 0%. CONCLUSIONS: Among all these drugs studied, adalimumab is the most cost-effective drug for the treatment of moderate to severe UC for a threshold of 30,000/QALY in Spain.
Assuntos
Anti-Inflamatórios/uso terapêutico , Colite Ulcerativa/tratamento farmacológico , Fármacos Gastrointestinais/uso terapêutico , Adalimumab/economia , Adalimumab/uso terapêutico , Anti-Inflamatórios/economia , Anticorpos Monoclonais/economia , Anticorpos Monoclonais/uso terapêutico , Anticorpos Monoclonais Humanizados/economia , Anticorpos Monoclonais Humanizados/uso terapêutico , Colite Ulcerativa/economia , Colite Ulcerativa/fisiopatologia , Análise Custo-Benefício , Fármacos Gastrointestinais/economia , Humanos , Infliximab/economia , Infliximab/uso terapêutico , Cadeias de Markov , Anos de Vida Ajustados por Qualidade de Vida , Índice de Gravidade de Doença , EspanhaAssuntos
Carvão Vegetal/efeitos adversos , Lavagem Gástrica/efeitos adversos , Pneumonia Aspirativa/induzido quimicamente , Insuficiência Respiratória/etiologia , Adulto , Broncoscopia , Carvão Vegetal/administração & dosagem , Feminino , Humanos , Pneumonia Aspirativa/diagnóstico , Pneumonia Aspirativa/terapia , Respiração Artificial , Insuficiência Respiratória/diagnóstico , Insuficiência Respiratória/terapia , Resultado do TratamentoRESUMO
No disponible