Cost Effectiveness of Tofacitinib for the Treatment of Moderate to Severe Active Ulcerative Colitis in Colombia

Fabio Gil, Fabian Juliao-Baños, Luisa Amador, Natalia Castano and Juan Manuel Reyes ()
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Fabio Gil: Clinica Colombia
Fabian Juliao-Baños: Hospital Pablo Tobon Uribe
Luisa Amador: Pfizer SAS
Natalia Castano: Pfizer SAS
Juan Manuel Reyes: Pfizer SAS

PharmacoEconomics - Open, 2022, vol. 6, issue 6, No 6, 837-846

Abstract: Abstract Objective The aim of this study was to evaluate the cost effectiveness of tofacitinib versus other treatment options currently available in Colombia in naïve to biologics (first-line) and exposed to biologics (second-line) patients with moderate to severe active ulcerative colitis (UC). Methods A Markov model was constructed with 8-week cycles, simulating a cohort of patients in a 5-year time horizon. The health states included remission, treatment response, active UC, and colectomy. The transition probabilities for the induction and maintenance phase were obtained from a network meta-analysis, and effectiveness was measured using quality-adjusted life-years (QALYs). Unit costs were derived from official national sources. Results For first line, the incremental cost-effectiveness ratio (ICER) per QALY was $883 for tofacitinib and $3619 for infliximab, compared with adalimumab. Sensitivity analysis showed that tofacitinib is cost effective in 45% of the iterations, adalimumab in 5%, and infliximab in 50%. Meanwhile, the ICER of adalimumab was $14,927 compared with tofacitinib in second-line treatment. In the sensitivity analysis, tofacitinib was cost effective in 64% of the iterations, followed by adalimumab in 36%. Infliximab and golimumab were not included due to data limitations in the network meta-analysis of second-line treatment. Conclusion The analysis suggests that in Colombia, treatment with tofacitinib for patients with moderate-to-severe UC is a cost-effective option in both lines compared with other treatment options.

Date: 2022
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DOI: 10.1007/s41669-022-00360-4

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