Cost-Effectiveness Analysis of Filgotinib as a First-Line Treatment for Biologic-Naive Patients With Ulcerative Colitis in Greece

OBJECTIVES: The aim of this study was to evaluate the cost-effectiveness of introducing filgotinib as a treatment option for patients with moderate to severe Ulcerative Colitis (UC) who are biologic-naïve in Greece compared to adalimumab, golimumab and vedolizumab.

METHODS: The cost-effectiveness analysis for treating moderate and severe UC in biologic-naïve patients, assesses both the costs and health outcomes of filgotinib versus comparators from a third-party payer perspective. The model, aligned with the SELECTION clinical trial's eligibility criteria, projects patient transitions through health states based on the Mayo score, over an 80-year lifetime horizon with a 3.5% discount on costs, life years, and quality-adjusted life years (QALYs). It utilizes clinical efficacy from a meta-analysis, serious infection rates, and quality of life metrics from EQ-5D data. Costs are calculated using official pricing adjusted for rebates and include pharmaceuticals, monitoring, surgery, and hospitalization.

RESULTS: Life expectancy was comparable across treatments, with minor QALY variations under 0.04. Filgotinib demonstrated substantial cost-effectiveness, with incremental cost-effectiveness ratios (ICERs) significantly below the €30,000 per QALY threshold: €11,032 versus adalimumab and €15,360 versus golimumab. Additionally, filgotinib was superior to vedolizumab, being both more effective and less costly. Sensitivity analyses, both deterministic and probabilistic, were conducted to test the robustness of these results against changes in key variables, confirming the stability and reliability of the findings.

CONCLUSIONS: Introducing filgotinib as a first-line treatment for biologic-naive patients with moderate to severe UC in Greece presents a cost-effective strategy, yielding significant savings for third-party payers. This study underscores the potential benefits of integrating filgotinib into the UC treatment landscape, providing critical insights for healthcare policymakers and stakeholders in Greece.