Objective: To determine the incremental cost-effectiveness ratios (ICERs) of two therapeutic regimens of infliximab for ankylosing spondylitis (AS).
Methods: 230 patients with active AS who were participating in a randomised controlled trial comparing two infliximab infusion modalities—every 6 weeks (Q6) and on demand (DEM)—were included in an economic evaluation within the trial. Data were collected by phone every 3 months for 1 year. Direct and indirect costs were calculated from a payer perspective. Health-related quality of life was assessed with a general health rating scale. ICERs were calculated for one 20% improvement (ASAS20), for one partial remission and for one quality-adjusted life year (QALY) gained.
Results: The Q6 regimen was significantly more efficacious than the DEM regimen but also more costly (€22 388 vs €17 596; p<0.001), because it required significantly more infliximab infusions per patient (8.4 vs 6.2). The ICERs of the Q6 to DEM regimen were €15 841 for one ASAS20 response, €23 296 for one partial remission and €50 760 for one QALY gained.
Conclusion: The administration of infliximab every 6 weeks is cost effective as compared with a DEM regimen; however, the ICER is close to the acceptability threshold of €50 000 for one QALY gained.
Trial registration number: NCT 00439283.
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▸ An additional figure and table are published online only at http://ard.bmj.com/content/vol69/issue2
Funding The study was funded by Schering-Plough.
Competing interests Honorarium from Schering-Plough France, Abbott and Wyeth.
Ethics approval Ethics committee approval from CPP d'Ile de France, Paris.
Patient consent Patient consent received.
Role of the authors in the study: Study design: Fautrel, Breban, Lenoir, Ravaud, Trape, Dougados. Analysis and interpretation of data: Fautrel, Benhamou, Roy, Ravaud. Manuscript preparation: Fautrel, Benhamou, Breban, Ravaud, Dougados.
Provenance and Peer review Not commissioned; externally peer reviewed.