Economic evaluation of infliximab, synthetic triple therapy and methotrexate in the treatment of newly diagnosed juvenile idiopathic arthritis
Abstract Background Evaluation of costs and short-term cost-effectiveness of infliximab plus methotrexate (IFX + MTX); triple therapy of hydroxychloquine, sulphasalazine, and methotrexate (TRIPLE); or methotrexate monotherapy (MTX) in patients with new-onset polyarticular juvenile idiopathic arthrit...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-11-01
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| Series: | Pediatric Rheumatology Online Journal |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12969-022-00748-w |
| _version_ | 1811319328252887040 |
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| author | Maarit Tarkiainen Pirjo Tynjälä Paula Vähäsalo Kristiina Aalto Liisa Kröger Katariina Rebane Pekka Lahdenne Janne Martikainen |
| author_facet | Maarit Tarkiainen Pirjo Tynjälä Paula Vähäsalo Kristiina Aalto Liisa Kröger Katariina Rebane Pekka Lahdenne Janne Martikainen |
| author_sort | Maarit Tarkiainen |
| collection | DOAJ |
| description | Abstract Background Evaluation of costs and short-term cost-effectiveness of infliximab plus methotrexate (IFX + MTX); triple therapy of hydroxychloquine, sulphasalazine, and methotrexate (TRIPLE); or methotrexate monotherapy (MTX) in patients with new-onset polyarticular juvenile idiopathic arthritis (JIA). Methods In a prospective multicenter study (ACUTE-JIA), costs and health outcomes of 60 randomized patients with new-onset disease-modifying anti-rheumatic drug (DMARD)-naïve polyarticular JIA were analyzed during the first year. A mapping algorithm was used to obtain utility values from Child Health Assessment Questionnaire (CHAQ). Wallace criteriae were used to assess clinically inactive disease (CID). Linear regression with non-parametric bootstrapping was used to adjust imbalances at baseline. Results Using prices for IFX biosimilar, adjusted annual mean (SD) costs of treatment (€) were 21,164 (4158), 12,136 (5286), and 18,300 (8635) on IFX + MTX, TRIPLE, and MTX, respectively. Incremental cost-effectiveness ratio (ICER) for IFX + MTX as compared with TRIPLE or MTX were 3442 € or 678 € per additional month spent in CID. Mean (SD) quality-adjusted life years (QALYs) for IFX + MTX, TRIPLE and MTX were 0.755 (0.065), 0.725 (0.062), and 0.686 (0.124). ICER for IFX + MTX vs TRIPLE was 294,433 €, and for IFX + MTX vs MTX 31,435 € per QALY gained. Conclusions In short-term, biosimilar IFX + MTX can be considered cost-effective when compared with MTX alone. TRIPLE was cost-effective when compared with MTX and showed cost advantage when compared with IFX + MTX. Cost per time spent in CID showed similar results than ICER evaluations. Trial registration This trial was primarily registered with the Ethical Board of Helsinki District University Hospital ( https://www.hus.fi ), clinical trial number 211864, and later with ClinicalTrials.gov, number NCT01015547. |
| first_indexed | 2024-04-13T12:40:38Z |
| format | Article |
| id | doaj.art-17423575bfb142178e736947117421ee |
| institution | Directory Open Access Journal |
| issn | 1546-0096 |
| language | English |
| last_indexed | 2024-04-13T12:40:38Z |
| publishDate | 2022-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Pediatric Rheumatology Online Journal |
| spelling | doaj.art-17423575bfb142178e736947117421ee2022-12-22T02:46:31ZengBMCPediatric Rheumatology Online Journal1546-00962022-11-012011810.1186/s12969-022-00748-wEconomic evaluation of infliximab, synthetic triple therapy and methotrexate in the treatment of newly diagnosed juvenile idiopathic arthritisMaarit Tarkiainen0Pirjo Tynjälä1Paula Vähäsalo2Kristiina Aalto3Liisa Kröger4Katariina Rebane5Pekka Lahdenne6Janne Martikainen7New Children’s Hospital, Helsinki University Central HospitalPediatric Research Center, University of HelsinkiPEDEGO Research Unit, University of OuluNew Children’s Hospital, Helsinki University Central HospitalDepartment of pediatrics, Kuopio University HospitalNew Children’s Hospital, Helsinki University Central HospitalNew Children’s Hospital, Helsinki University Central HospitalSchool of Pharmacy, University of Eastern FinlandAbstract Background Evaluation of costs and short-term cost-effectiveness of infliximab plus methotrexate (IFX + MTX); triple therapy of hydroxychloquine, sulphasalazine, and methotrexate (TRIPLE); or methotrexate monotherapy (MTX) in patients with new-onset polyarticular juvenile idiopathic arthritis (JIA). Methods In a prospective multicenter study (ACUTE-JIA), costs and health outcomes of 60 randomized patients with new-onset disease-modifying anti-rheumatic drug (DMARD)-naïve polyarticular JIA were analyzed during the first year. A mapping algorithm was used to obtain utility values from Child Health Assessment Questionnaire (CHAQ). Wallace criteriae were used to assess clinically inactive disease (CID). Linear regression with non-parametric bootstrapping was used to adjust imbalances at baseline. Results Using prices for IFX biosimilar, adjusted annual mean (SD) costs of treatment (€) were 21,164 (4158), 12,136 (5286), and 18,300 (8635) on IFX + MTX, TRIPLE, and MTX, respectively. Incremental cost-effectiveness ratio (ICER) for IFX + MTX as compared with TRIPLE or MTX were 3442 € or 678 € per additional month spent in CID. Mean (SD) quality-adjusted life years (QALYs) for IFX + MTX, TRIPLE and MTX were 0.755 (0.065), 0.725 (0.062), and 0.686 (0.124). ICER for IFX + MTX vs TRIPLE was 294,433 €, and for IFX + MTX vs MTX 31,435 € per QALY gained. Conclusions In short-term, biosimilar IFX + MTX can be considered cost-effective when compared with MTX alone. TRIPLE was cost-effective when compared with MTX and showed cost advantage when compared with IFX + MTX. Cost per time spent in CID showed similar results than ICER evaluations. Trial registration This trial was primarily registered with the Ethical Board of Helsinki District University Hospital ( https://www.hus.fi ), clinical trial number 211864, and later with ClinicalTrials.gov, number NCT01015547.https://doi.org/10.1186/s12969-022-00748-wJuvenile idiopathic arthritisBiological therapyDisease-modifying anti-rheumatic drugs; health economic evaluation |
| spellingShingle | Maarit Tarkiainen Pirjo Tynjälä Paula Vähäsalo Kristiina Aalto Liisa Kröger Katariina Rebane Pekka Lahdenne Janne Martikainen Economic evaluation of infliximab, synthetic triple therapy and methotrexate in the treatment of newly diagnosed juvenile idiopathic arthritis Pediatric Rheumatology Online Journal Juvenile idiopathic arthritis Biological therapy Disease-modifying anti-rheumatic drugs; health economic evaluation |
| title | Economic evaluation of infliximab, synthetic triple therapy and methotrexate in the treatment of newly diagnosed juvenile idiopathic arthritis |
| title_full | Economic evaluation of infliximab, synthetic triple therapy and methotrexate in the treatment of newly diagnosed juvenile idiopathic arthritis |
| title_fullStr | Economic evaluation of infliximab, synthetic triple therapy and methotrexate in the treatment of newly diagnosed juvenile idiopathic arthritis |
| title_full_unstemmed | Economic evaluation of infliximab, synthetic triple therapy and methotrexate in the treatment of newly diagnosed juvenile idiopathic arthritis |
| title_short | Economic evaluation of infliximab, synthetic triple therapy and methotrexate in the treatment of newly diagnosed juvenile idiopathic arthritis |
| title_sort | economic evaluation of infliximab synthetic triple therapy and methotrexate in the treatment of newly diagnosed juvenile idiopathic arthritis |
| topic | Juvenile idiopathic arthritis Biological therapy Disease-modifying anti-rheumatic drugs; health economic evaluation |
| url | https://doi.org/10.1186/s12969-022-00748-w |
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