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Number needed to treat and cost per remitter for biologic treatments of Crohn's disease in Japan.
J Med Econ. 2020 Jan; 23(1):80-85.JM

Abstract

Aims:

Adalimumab, infliximab, and ustekinumab have been approved for patients with moderate-to-severe Crohn's disease in Japan. This study compared the relative efficacy and cost-effectiveness of adalimumab, infliximab, and ustekinumab in patients with Crohn's disease based on data from randomized controlled trials.

Methods:

Data were extracted from four phase 3 clinical trials: CHARM, NCT00445432, ACCENT I, and IM-UNITI. A network meta-analysis (NMA) compared 1-year clinical remission rates in patients who responded to treatment during an induction phase. Remission was defined as a Crohn's Disease Activity Index score <150. The number needed to treat (NNT) was defined as the inverse of the risk reduction (compared with placebo) estimated from the NMA among initial responders. Cost per incremental remitter was calculated based on the projected per patient drug cost (2018 Japanese Yen [¥]) and the NNT.

Results:

Among initial responders, the remission rates were 45.2%, 31.9%, 27.4%, 24.1%, and 15.6% for adalimumab 40 mg every other week (EOW), infliximab 5 mg/kg every 8 weeks, ustekinumab 90 mg every 8 weeks, ustekinumab 90 mg every 12 weeks, and placebo, respectively. The NNT was the lowest for adalimumab 40 mg EOW. Compared with adalimumab, the incremental cost per remitter was numerically higher for infliximab (¥5,375,470) and statistically higher for ustekinumab 90 mg every 8 weeks and ustekinumab 90 mg every 12 weeks (¥42,788,597 and ¥41,495,543, respectively).Limitations: Indirect comparisons are limited by the availability of suitable clinical evidence and there may be residual heterogeneity that could not be adjusted for.

Conclusion:

Adalimumab was associated with a numerically lower cost per remitter compared with infliximab and a statistically lower cost per remitter compared with ustekinumab in patients with moderate-to-severe Crohn's disease in Japan.

Authors+Show Affiliations

Center for Gastroenterology and Inflammatory Bowel Disease, Ofuna Chuo Hospital, Kanagawa, Japan.AbbVie GK, Tokyo, Japan.AbbVie GK, Tokyo, Japan.AbbVie GK, Tokyo, Japan.Analysis Group Inc, Los Angeles, CA, USA.Analysis Group Inc, Los Angeles, CA, USA.

Pub Type(s)

Journal Article
Meta-Analysis

Language

eng

PubMed ID

31294641

Citation

Ueno, Fumiaki, et al. "Number Needed to Treat and Cost Per Remitter for Biologic Treatments of Crohn's Disease in Japan." Journal of Medical Economics, vol. 23, no. 1, 2020, pp. 80-85.
Ueno F, Doi M, Kawai Y, et al. Number needed to treat and cost per remitter for biologic treatments of Crohn's disease in Japan. J Med Econ. 2020;23(1):80-85.
Ueno, F., Doi, M., Kawai, Y., Ukawa, N., Cammarota, J., & Betts, K. A. (2020). Number needed to treat and cost per remitter for biologic treatments of Crohn's disease in Japan. Journal of Medical Economics, 23(1), 80-85. https://doi.org/10.1080/13696998.2019.1642900
Ueno F, et al. Number Needed to Treat and Cost Per Remitter for Biologic Treatments of Crohn's Disease in Japan. J Med Econ. 2020;23(1):80-85. PubMed PMID: 31294641.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Number needed to treat and cost per remitter for biologic treatments of Crohn's disease in Japan. AU - Ueno,Fumiaki, AU - Doi,Michio, AU - Kawai,Yumi, AU - Ukawa,Naoto, AU - Cammarota,Jordan, AU - Betts,Keith A, Y1 - 2019/08/13/ PY - 2019/7/12/pubmed PY - 2020/7/1/medline PY - 2019/7/12/entrez KW - Crohn’s disease KW - I10 KW - I19 KW - Japan KW - adalimumab KW - cost per remitter KW - infliximab KW - network meta-analysis KW - ustekinumab SP - 80 EP - 85 JF - Journal of medical economics JO - J Med Econ VL - 23 IS - 1 N2 - Aims: Adalimumab, infliximab, and ustekinumab have been approved for patients with moderate-to-severe Crohn's disease in Japan. This study compared the relative efficacy and cost-effectiveness of adalimumab, infliximab, and ustekinumab in patients with Crohn's disease based on data from randomized controlled trials.Methods: Data were extracted from four phase 3 clinical trials: CHARM, NCT00445432, ACCENT I, and IM-UNITI. A network meta-analysis (NMA) compared 1-year clinical remission rates in patients who responded to treatment during an induction phase. Remission was defined as a Crohn's Disease Activity Index score <150. The number needed to treat (NNT) was defined as the inverse of the risk reduction (compared with placebo) estimated from the NMA among initial responders. Cost per incremental remitter was calculated based on the projected per patient drug cost (2018 Japanese Yen [¥]) and the NNT.Results: Among initial responders, the remission rates were 45.2%, 31.9%, 27.4%, 24.1%, and 15.6% for adalimumab 40 mg every other week (EOW), infliximab 5 mg/kg every 8 weeks, ustekinumab 90 mg every 8 weeks, ustekinumab 90 mg every 12 weeks, and placebo, respectively. The NNT was the lowest for adalimumab 40 mg EOW. Compared with adalimumab, the incremental cost per remitter was numerically higher for infliximab (¥5,375,470) and statistically higher for ustekinumab 90 mg every 8 weeks and ustekinumab 90 mg every 12 weeks (¥42,788,597 and ¥41,495,543, respectively).Limitations: Indirect comparisons are limited by the availability of suitable clinical evidence and there may be residual heterogeneity that could not be adjusted for.Conclusion: Adalimumab was associated with a numerically lower cost per remitter compared with infliximab and a statistically lower cost per remitter compared with ustekinumab in patients with moderate-to-severe Crohn's disease in Japan. SN - 1941-837X UR - https://www.unboundmedicine.com/medline/citation/31294641/Number_needed_to_treat_and_cost_per_remitter_for_biologic_treatments_of_Crohn's_disease_in_Japan_ L2 - https://www.tandfonline.com/doi/full/10.1080/13696998.2019.1642900 DB - PRIME DP - Unbound Medicine ER -