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. 2021 Jul 12:8:69-79.
doi: 10.33393/grhta.2021.2267. eCollection 2021 Jan-Dec.

Costo per responder di upadacitinib e abatacept nel trattamento dell’artrite reumatoide da moderata a grave in Italia

[Article in Italian]
Affiliations

Costo per responder di upadacitinib e abatacept nel trattamento dell’artrite reumatoide da moderata a grave in Italia

[Article in Italian]
Roberto Caporali et al. Glob Reg Health Technol Assess. .

Abstract

Purpose:: The objective of this economic evaluation was to compare the cost per responder between upadacitinib and abatacept (intravenous [iv] or subcutaneous [sc]) in patients with moderate-to-severe Rheumatoid Arthritis (RA) in Italy.

Methods:: The clinical efficacy was assessed based on SELECT-CHOICE study results. The clinical efficacy of upadacitinib and abatacept (iv or sc) was measured by Clinical Remission (CR), Low Disease Activity (LDA) and American College of Rheumatology response (ACR20, 50 and 70). The treatment cost was based on the number of administrations dispensed at 12 or 24 weeks. The cost per responder was adopted as a cost-effectiveness indicator.

Results:: Independent of the clinical efficacy measure used and the duration of treatment considered, the cost per responder was consistently lower for upadacitinib compared to abatacept (iv or sc) across all clinical measures. For example, considering the CR at 24 weeks, the cost per responder for upadacitinib was € 9,417 compared to € 17,817 for abatacept sc or to € 23,110 for abatacept iv. The differences in the cost per responder between upadacitinib and abatacept (iv or sc) increased when higher ACR response levels were considered.

Conclusions:: These results suggested that upadacitinib is a cost-effectiveness option compared to abatacept (iv or sc) from the perspective of the Italian National Health Service in patients with moderate-to-severe Rheumatoid Arthritis in Italy.

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Conflict of interest statement

Conflict of interest: The authors declare no conflict of interest.

Figures

Fig. 1 -
Fig. 1 -
Clinical Remission: costo per responder a 12 e a 24 settimane.
Fig. 2 -
Fig. 2 -
Low Disease Activity: costo per responder a 12 e a 24 settimane.
Fig. 3 -
Fig. 3 -
ACR20, ACR50 e ACR70: costo per responder a 12 settimane.
Fig. 4 -
Fig. 4 -
ACR20, ACR50 e ACR70: costo per responder a 24 settimane.
Fig. 5 -
Fig. 5 -
Analisi di sensibilità sconto costo per responder a 12 e a 24 settimane: Clinical Remission. Note: A = CR a 12 settimane upadacitinib vs abatacept sc; B = CR a 24 settimane upadacitinib vs abatacept sc; C = CR a 12 settimane upadacitinib vs abatacept ev; D = CR a 24 settimane upadacitinib vs abatacept ev. Legenda: grigio = costo per responder di upadacitinib < costo per responder di abatacept ev o sc; nero = costo per responder di upadacitinib > costo per responder di abatacept ev o sc.
Fig. 6 -
Fig. 6 -
Analisi di sensibilità sconto costo per responder a 12 e a 24 settimane: Low Disease Activity. Note: A = LDA a 12 settimane upadacitinib vs abatacept sc; B = LDA a 24 settimane upadacitinib vs abatacept sc; C = LDA a 12 settimane upadacitinib vs abatacept ev; D = LDA a 24 settimane upadacitinib vs abatacept ev. Legenda: grigio = costo per responder di upadacitinib < costo per responder di abatacept ev o sc; nero = costo per responder di upadacitinib > costo per responder di abatacept ev o sc.
Fig. 7 -
Fig. 7 -
Analisi di sensibilità sconto costo per responder a 12 e a 24 settimane: ACR20. Note: A = ACR20 a 12 settimane upadacitinib vs abatacept sc; B = ACR20 a 24 settimane upadacitinib vs abatacept sc; C = ACR20 a 12 settimane upadacitinib vs abatacept ev; D = ACR20 a 24 settimane upadacitinib vs abatacept ev. Legenda: grigio = costo per responder di upadacitinib < costo per responder di abatacept ev o sc; nero = costo per responder di upadacitinib > costo per responder di abatacept ev o sc.
Fig. 8 -
Fig. 8 -
Analisi di sensibilità sconto costo per responder a 12 e a 24 settimane: ACR50. Note: A = ACR50 a 12 settimane upadacitinib vs abatacept sc; B = ACR50 a 24 settimane upadacitinib vs abatacept sc; C = ACR50 a 12 settimane upadacitinib vs abatacept ev; D = ACR50 a 24 settimane upadacitinib vs abatacept ev. Legenda: grigio = costo per responder di upadacitinib < costo per responder di abatacept ev o sc; nero = costo per responder di upadacitinib > costo per responder di abatacept ev o sc.
Fig. 9 -
Fig. 9 -
Analisi di sensibilità sconto costo per responder a 12 e a 24 settimane: ACR70. Note: A = ACR70 a 12 settimane upadacitinib vs abatacept sc; B = ACR70 a 24 settimane upadacitinib vs abatacept sc; C = ACR70 a 12 settimane upadacitinib vs abatacept ev; D = ACR70 a 24 settimane upadacitinib vs abatacept ev. Legenda: grigio = costo per responder di upadacitinib < costo per responder di abatacept ev o sc; nero = costo per responder di upadacitinib > costo per responder di abatacept ev o sc.

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