A Systematic Review of Models Used in Cost-Effectiveness of Treatments in Spondyloarthritis

Main Article Content

Liudan Tu Ya Xie Jieruo Gu

Abstract

This review was aimed to evaluate health economic models used in evaluations of different treatment strategies in spondyloarthritis (SpA). Model-based health economic evaluation studies are increasing and complex models with short-term and long-term horizon are applied to investigate the cost-effectiveness of SpA treatments. The objective of this study was to carry out a systematic review of the evolution of health economic models used in the treatment of SpA. Electronic searches within MEDLINE and EMBASE were carried out using a predefined search strategy. Inclusion and exclusion criteria were used to select relevant studies. Data on country, intervention, evaluation perspective, type of model, time horizon, types of costs and effectiveness measurement were extracted. Eighteen models were described in 22 publications, of which 81.8% were European. Study perspectives included the societal (n=6), healthcare system and payer (n=14), or patient and government (n=1). Time horizon ranged from 52 weeks to lifetime. Markov model was the most frequently used model, only one individual patient simulation models accounting for uncertainty in multiple parameters was reported. Most studies compared different biologics (including different TNFi/biosimilar and IL-17A antibody) with conventional care (NSAIDs) because of the high prize. Only half of studies took indirect costs into account. Modeling is of importance in health economic evaluations of SpA treatment. Long-term costs especially indirect costs should be considered when comparing different treatment alternatives in order to provide more information for policy makers and clinicians.

Keywords: spondyloarthritis, cost-effectiveness, model

Article Details

How to Cite
TU, Liudan; XIE, Ya; GU, Jieruo. A Systematic Review of Models Used in Cost-Effectiveness of Treatments in Spondyloarthritis. Medical Research Archives, [S.l.], v. 9, n. 6, june 2021. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/2446>. Date accessed: 22 dec. 2024. doi: https://doi.org/10.18103/mra.v9i6.2446.
Section
Review Articles

References

1. Kotsis K, Voulgari PV, Drosos AA, Carvalho AF, Hyphantis T. Health-related quality of life in patients with ankylosing spondylitis: a comprehensive review. Expert Rev Pharmacoecon Outcomes Res. 2014;14(6):857-872.
2. Wang R, Ward MM. Epidemiology of axial spondyloarthritis: an update. Current opinion in rheumatology. 2018;30(2):137-143.
3. Boonen A, Sieper J, van der Heijde D, et al. The burden of non-radiographic axial spondyloarthritis. Semin Arthritis Rheum. 2015;44(5):556-562.
4. Lopez-Medina C, Ramiro S, van der Heijde D, Sieper J, Dougados M, Molto A. Characteristics and burden of disease in patients with radiographic and non-radiographic axial Spondyloarthritis: a comparison by systematic literature review and meta-analysis. RMD Open. 2019;5(2):e001108.
5. Boonen A, Severens JL. Ankylosing spondylitis: what is the cost to society, and can it be reduced? Best Pract Res Clin Rheumatol. 2002;16(4):691-705.
6. Martindale J, Shukla R, Goodacre J. The impact of ankylosing spondylitis/axial spondyloarthritis on work productivity. Best Pract Res Clin Rheumatol. 2015;29(3):512-523.
7. Castillo-Ortiz JD, Ramiro S, Landewe R, et al. Work Outcome in Patients With Ankylosing Spondylitis: Results From a 12-Year Followup of an International Study. Arthritis Care Res (Hoboken). 2016;68(4):544-552.
8. Ward MM, Deodhar A, Gensler LS, et al. 2019 Update of the American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network Recommendations for the Treatment of Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis. Arthritis Rheumatol. 2019;71(10):1599-1613.
9. Kobelt G, Andlin-Sobocki P, Brophy S, Jonsson L, Calin A, Braun J. The burden of ankylosing spondylitis and the cost-effectiveness of treatment with infliximab (Remicade). Rheumatology (Oxford, England). 2004;43(9):1158-1166.
10. Jansen JP, Pellissier J, Choy EH, et al. Economic evaluation of etoricoxib versus non-selective NSAIDs in the treatment of ankylosing spondylitis in the UK. Current medical research and opinion. 2007;23(12):3069-3078.
11. Kobelt G, Sobocki P, Mulero J, Gratacos J, Collantes-Estevez E, Braun J. The cost-effectiveness of infliximab in the treatment of ankylosing spondylitis in Spain. Comparison of clinical trial and clinical practice data. Scandinavian journal of rheumatology. 2008;37(1):62-71.
12. Gaujoux-Viala C, Fautrel B. Cost effectiveness of therapeutic interventions in ankylosing spondylitis: a critical and systematic review. Pharmacoeconomics. 2012;30(12):1145-1156.
13. Moher D, Liberati A, Tetzlaff J, Altman DG, Group P. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Bmj. 2009;339:b2535.
14. Kobelt G, Andlin-Sobocki P, Maksymowych WP. The cost-effectiveness of infliximab (Remicade) in the treatment of ankylosing spondylitis in Canada. The Journal of rheumatology. 2006;33(4):732-740.
15. Neilson AR, Sieper J, Deeg M. Cost-effectiveness of etanercept in patients with severe ankylosing spondylitis in Germany. Rheumatology (Oxford, England). 2010;49(11):2122-2134.
16. Ara RM, Reynolds AV, Conway P. The cost-effectiveness of etanercept in patients with severe ankylosing spondylitis in the UK. Rheumatology (Oxford, England). 2007;46(8):1338-1344.
17. Borse RH, Kachroo S, Brown C, McCann E, Insinga RP. Cost-effectiveness Analysis of Golimumab in the Treatment of Non-Radiographic Axial Spondyloarthritis in Scotland. Rheumatology and therapy. 2018;5(1):57-73.
18. Jansen JP, Gaugris S, Choy EH, Ostor A, Nash JT, Stam W. Cost effectiveness of etoricoxib versus celecoxib and non-selective NSAIDS in the treatment of ankylosing spondylitis. PharmacoEconomics. 2010;28(4):323-344.
19. Jansen JP, Taylor SD. Cost-Effectiveness Evaluation of Etoricoxib versus Celecoxib and Nonselective NSAIDs in the Treatment of Ankylosing Spondylitis in Norway. International journal of rheumatology. 2011;2011:160326.
20. Borse RH, Brown C, Muszbek N, Chaudhary MA, Kachroo S. Cost-Effectiveness of Golimumab in Ankylosing Spondylitis from the UK Payer Perspective. Rheumatol Ther. 2017;4(2):427-443.
21. Purmonen T, Puolakka K, Mishra D, Gunda P, Martikainen J. Cost-effectiveness of secukinumab compared to other biologics in the treatment of ankylosing spondylitis in Finland. ClinicoEconomics and outcomes research : CEOR. 2019;11:159-168.
22. Purmonen T, Tormalehto S, Wahlman H, Puolakka K. Budget impact analysis of secukinumab versus adalimumab in the treatment of ankylosing spondylitis. Journal of medical economics. 2019;22(2):151-157.
23. Tran-Duy A, Boonen A, van de Laar MAFJ, Franke AC, Severens JL. A discrete event modelling framework for simulation of long-term outcomes of sequential treatment strategies for ankylosing spondylitis. Annals of the rheumatic diseases. 2011;70(12):2111-2118.
24. Tran-Duy A, Boonen A, van de Laar MAFJ, Severens JL. Impact on total population health and societal cost, and the implication on the actual cost-effectiveness of including tumour necrosis factor-alpha antagonists in management of ankylosing spondylitis: a dynamic population modelling study. Cost effectiveness and resource allocation : C/E. 2015;13:18.
25. Le QA, Kang JH, Lee S, Delevry D. Cost-Effectiveness of Treatment Strategies with Biologics in Accordance with Treatment Guidelines for Ankylosing Spondylitis: A Patient-Level Model. Journal of managed care & specialty pharmacy. 2020;26(10):1219-1231.
26. Boonen A, van der Heijde D, Severens JL, et al. Markov model into the cost-utility over five years of etanercept and infliximab compared with usual care in patients with active ankylosing spondylitis. Annals of the rheumatic diseases. 2006;65(2):201-208.
27. Botteman MF, Hay JW, Luo MP, Curry AS, Wong RL, van Hout BA. Cost effectiveness of adalimumab for the treatment of ankylosing spondylitis in the United Kingdom. Rheumatology (Oxford, England). 2007;46(8):1320-1328.
28. Emery P, Van Keep M, Beard S, et al. Cost Effectiveness of Secukinumab for the Treatment of Active Ankylosing Spondylitis in the UK. PharmacoEconomics. 2018;36(8):1015-1027.
29. Goeree R, Chiva-Razavi S, Gunda P, Jain M, Jugl SM. Cost-effectiveness analysis of secukinumab in ankylosing spondylitis from the Canadian perspective. Journal of medical economics. 2019;22(1):45-52.
30. Kobelt G, Sobocki P, Sieper J, Braun J. Comparison of the cost-effectiveness of infliximab in the treatment of ankylosing spondylitis in the United Kingdom based on two different clinical trials. International journal of technology assessment in health care. 2007;23(3):368-375.
31. Schofield D, Shrestha R, Cunich M. The economic impacts of using adalimumab (Humira) for reducing pain in people with ankylosing spondylitis: A microsimulation study for Australia. International journal of rheumatic diseases. 2018;21(5):1106-1113.
32. Colombo GL, Di Matteo S, Martinotti C, et al. Budget impact model of secukinumab for the treatment of moderate-to-severe psoriasis, psoriatic arthritis, and ankylosing spondylitis in Italy: a cross-indication initiative. ClinicoEconomics and outcomes research : CEOR. 2018;10:477-491.
33. Barton P, Bryan S, Robinson S. Modelling in the economic evaluation of health care: selecting the appropriate approach. J Health Serv Res Policy. 2004;9(2):110-118.
34. Si L, Winzenberg TM, Palmer AJ. A systematic review of models used in cost-effectiveness analyses of preventing osteoporotic fractures. Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA. 2014;25(1):51-60.
35. Sugrue DM, Ward T, Rai S, McEwan P, van Haalen HGM. Economic Modelling of Chronic Kidney Disease: A Systematic Literature Review to Inform Conceptual Model Design. Pharmacoeconomics. 2019;37(12):1451-1468.
36. Briggs A, Sculpher M. An introduction to Markov modelling for economic evaluation. Pharmacoeconomics. 1998;13(4):397-409.
37. Caro JJ, Moller J, Getsios D. Discrete event simulation: the preferred technique for health economic evaluations? Value Health. 2010;13(8):1056-1060.
38. Zrubka Z, Rencz F, Zavada J, et al. EQ-5D studies in musculoskeletal and connective tissue diseases in eight Central and Eastern European countries: a systematic literature review and meta-analysis. Rheumatology international. 2017;37(12):1957-1977.
39. Rencz F, Gulacsi L, Drummond M, et al. EQ-5D in Central and Eastern Europe: 2000-2015. Qual Life Res. 2016;25(11):2693-2710.
40. Boonen A, van der Heijde D, Landewe R, et al. How do the EQ-5D, SF-6D and the well-being rating scale compare in patients with ankylosing spondylitis? Annals of the rheumatic diseases. 2007;66(6):771-777.
41. Lindstrom U, Olofsson T, Wedren S, Qirjazo I, Askling J. Biological treatment of ankylosing spondylitis: a nationwide study of treatment trajectories on a patient level in clinical practice. Arthritis research & therapy. 2019;21(1):128.
42. Bonafede M, Fox KM, Watson C, Princic N, Gandra SR. Treatment patterns in the first year after initiating tumor necrosis factor blockers in real-world settings. Advances in therapy. 2012;29(8):664-674.
43. Glintborg B, Ostergaard M, Krogh NS, et al. Clinical response, drug survival and predictors thereof in 432 ankylosing spondylitis patients after switching tumour necrosis factor alpha inhibitor therapy: results from the Danish nationwide DANBIO registry. Annals of the rheumatic diseases. 2013;72(7):1149-1155.
44. Atiqi S, Hooijberg F, Loeff FC, Rispens T, Wolbink GJ. Immunogenicity of TNF-Inhibitors. Front Immunol. 2020;11:312.
45. Malinowski KP, Kawalec P. The indirect costs of ankylosing spondylitis: a systematic review and meta-analysis. Expert Rev Pharmacoecon Outcomes Res. 2015;15(2):285-300.
46. Hay J, Jackson J. Panel 2: methodological issues in conducting pharmacoeconomic evaluations--modeling studies. Value Health. 1999;2(2):78-81.
47. Soto J. Health economic evaluations using decision analytic modeling. Principles and practices--utilization of a checklist to their development and appraisal. International journal of technology assessment in health care. 2002;18(1):94-111.