Cost-Effectiveness Analysis of Adalimumab Versus Cyclosporine for Vogt-Koyanagi-Harada Disease
Purpose
To compare the 26-week cost-effectiveness of adalimumab-corticosteroids (ADA-CS) and cyclosporine-corticosteroids (CSA-CS) for Vogt-Koyanagi-Harada (VKH).
Methods
The costs data were calculated on the basis of consultation records. The EuroQol-5D-3L questionnaire (EQ-5D-3L) and the 25-item National Eye Institute Visual Function questionnaire (NEI VFQ-25) were administered before treatment and at the final visit, respectively to evaluate health-related quality of life (HRQoL) and visual-related quality of life (VRQoL). The incremental cost-effectiveness ratio (ICER) was the primary outcome. The quality-adjusted life years (QALYs) were computed based on the time and the HRQoL scores.
Results
For the VKH patients, the ICER at 26 weeks was $62,425/QALY. Costs in the ADA-CS group were more expensive than in the CSA-CS group (mean difference [ΔA-C]: $2,497) with more gains in QALYs (mean difference [ΔA-C]:0.04). The VRQoL outcome over a 26-week treatment period based on the NEI VFQ-25 questionnaire was significantly improved (P<0.05). The HRQoL improved after 26-week therapy but had no significant difference (P>0.05). The probability of the ADA-CS strategy being cost-effectiveness at willingness to pay (WTP) thresholds of $12,000/QALY and $36,000/QALY was 0.17 and 0.41, respectively.
Conclusion
The estimated ICERs were not within the generally accepted cost-effectiveness thresholds, suggesting that the CSA-CS strategy may be recommended as the preferred initial choice for the majority of VKH patients.
Conflict of interest
No
Authors 1
Last name
DAI
Initials of first name(s)
LY
Department
The First Affiliated Hospital of Chongqing Medical University
City
Chongqing
Country
China
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