ICERs of biological agents published in cost-effectiveness analyses
| Drug | Study, PYR | ICER (year of pricing, if specified and different from year of publication) | Tested versus |
|---|---|---|---|
| Adalimumab | Chiou et al 200442 | #m(c): dominated by ETA (+MTX) | Anakinra (+MTX) |
| Bansback et al 200541 | #**m: 41,561 € (2001) | DMARD | |
| #**c: 34,167 € | |||
| Chen et al 200628 | § (first line◊), m: 53,000 £ (2004) | DMARD | |
| § (first line), c: 171,000 £ | |||
| # (last active◊), m: 40,000 £ | |||
| # (last active), c: 30,000 £ | |||
| s: following ETA 240,000 £ | |||
| following IFX+MTX 140,000 £ | |||
| Spalding 200629 | §m: 63,769 US$ | MTX | |
| §c: 194,589 US$ | |||
| Brennan et al 200739 | #**m: 23,280 £ | DMARD | |
| #**c: 27,111 £ | |||
| s: 24,320 £ | |||
| Wailoo et al 200840 | ADA and ETA are equally likely to be cost effective at a threshold of 110,000 US$ | ||
| Probability of cost effectiveness at a threshold of 60,000 US$: 0.59 | |||
| Davies et al 200932 | §c: 23,377 US$ | DMARD | |
| Etanercept | Choi et al 200055 | #m: dominated | |
| #c: 34,800 US$ per ACR70 WR, and 42,600 $US per ACR20 WR | |||
| Choi et al 200220 | 40,800 US$ per patient with ACR70 WR (1999) | MTX | |
| 41,900 US$ per ACR20 WR | SSZ | ||
| Jobanputra et al 200252 | #**: 72,000 £ (2000) | DMARD | |
| Brennan et al 200445 | #**m: 16,330 £ (2001), direct costs only | ||
| indirect costs included: 8,439 £ | |||
| Chiou et al 200442 | ADA and IFX where dominated by ETA | Anakinra | |
| #m: 13,387 US$ (2003) | Anakinra+MTX | ||
| #c: 7,925 US$ | |||
| Kobelt 200444 | #**c: ETA and IFX ITT 53,600 € (2002) | ||
| Welsing et al 200436 | #**: 163,556 £ (2002) | DMARD | |
| dominated by LEF(in case of non-response after 3 months)switch to ETA | |||
| Bansback et al 200541 | #**m: 36,927 € | DMARD | |
| #**c: 35,760 € | |||
| Kobelt et al 200543 | #c: 46,494 € (2004) (treatment for 10 years) | DMARD | |
| Chen et al 200628 | § (first line◊), m: 49,000 £ (2004) | DMARD | |
| § (first line), c: 78,000 £ | |||
| # (last active◊), m: 24,000 £ | |||
| # (last active), c: 24,000 £ | |||
| s: following ADA 52,000 £ | |||
| following IFX+MTX 47,000 £ | |||
| following ADA and IFX as 3rd TNFi 54,900 £ | |||
| Coyle et al 200653 | #**m: 144,700 Can$ (2003) | DMARD | |
| last after gold 125,700 Can$ | |||
| Spalding and Hay 200629 | §m: 89,772 US$ (2004) | MTX | |
| Brennan et al 200739 | #**m: 23,280 £ | DMARD | |
| #**c: 27,111 £ | |||
| s: 24,320 £ | |||
| Wailoo et al 200840 | ADA and ETA are equally likely to be cost effective at a threshold of 110,000 US$ | ||
| Probability of cost effectiveness at a threshold of 60,000 US$: 0.41 | |||
| Fautrel et al 2008 AB30 31 | §m: 24,655 € in severe RA, 30,199 € in highly active RA | 2nd line ETA added to MTX. | |
| 34,560 € in severe RA, 35,158 € in highly active RA | No TNFi | ||
| Davies et al 200932 | §m: dominated | DMARD | |
| s: following MTX+ADA, 19,663 US$ | DMARD | ||
| following MTX+ADA, 42,727 US$ | Single TNFi | ||
| Infliximab | Jobanputra et al 200252 | #**: 95,000 £ (2000) | DMARD |
| Wong et al 200249 | #c: 30,500 US$ (1998) (9,100 US$ incuding indirect costs) | DMARD | |
| Kobelt et al 200348 | #c: 29,900 £ (UK), 16,100 € (Sweden) (2000) | ||
| Chiou et al 200442 | #c: dominated by ETA | Anakinra+MTX | |
| Kobelt et al 200444 | #**c: ETA and IFX ITT 53,600 € (2002) | ||
| Barbieri et al 200547 | #c: 33,618 £ | ||
| Bansback et al 200541 | #**c: 48,333 € | DMARD | |
| Chen et al 200628 | § (first line◊), c: 654,000 £ (2004) | DMARD | |
| # (last active◊), c: 38,000 £ | DMARD | ||
| s: following ADA 240,000 £ | DMARD | ||
| following ETA 190,000 £ | |||
| Coyle et al 200653 | #**c: 113,000 Can$ (2003) | DMARD | |
| last after gold: 97,800 Can$ | |||
| Spalding and Hay 200629 | §c: 409,523 US$ (2004) | MTX | |
| Brennan et al 200739 | #**m: 23,280 £ | DMARD | |
| #**c: 27,111 £ | |||
| s: 24,320 £ | |||
| Marra et al 200746 | #c: 32,018 Can$ (2004) (HUI3), 46,322 (EQ-5D), 53,429 (HUI2), 69,826 (SF-6D), depending on the utility measure used to derive QALYs | ||
| Wailoo et al 200840 | Probability of cost effectiveness at a threshold of 60,000 US$: 0.00 | ||
| Sensitivity analysis: scenario ‘no dose increase for IFX’: probability of cost effectiveness at a threshold of 60,000 US$: 1.00 | |||
| Davies et al 200932 | §c: dominated | ||
| TNFiNS | Finckh et al 200921 | §c: 727 894 US$ | |
| §c: dominated | |||
| DMARD | Finckh et al 200921 | §m: 4849 US$ |
↵§ DMARD naïve (ie, first-line treatment),
↵# after DMARD failure
(*after failure of one DMARD,
↵** after failure of more than one DMARD),
↵◊ In their analyses, the authors also differentiated between ‘early RA’ and ‘first-line TNFi’, as well as between ‘late RA’ and ‘TNFiused as last drug’ yet ICERs reported did not differ substantially).
AB; published in abstract form only; ADA, adalimumab; c, combination therapy (with MTX, if not otherwise stated); DMARD, disease-modifying antirheumatic drug; ETA, etanercept; ICER, incremental cost-effectiveness ratio; IFX, infliximab; ITT, intention to treat analysis; m, monotherapy; MTX, methotrexate; NS, not specified; NSAIDs, non-steroidal anti-inflammatory drugs; PYR, year of publication; QALY, quality-adjusted life-year; RA, rheumatoid arthritis; s, sequential use; SSZ, sulfasalazine; TNFi, TNFa inhibitors; WR, weighted response.