ALIGNMENT OF PATIENT-REPORTED OUTCOME IMPROVEMENTS WITH ICER COST-EFFECTIVENESS AND VALUE-BASED PRICE RECOMMENDATIONS IN RHEUMATOID ARTHRITIS
Author(s)
Yoonha Chung, PharmD Candidate of 2027, Joshua H. Saavedra, PharmD Candidate of 2027, Eera Vedanti, PharmD Candidate of 2027, Vincent Tan, PharmD Candidate of 2027, Carsyn Norway, PharmD, Chintan Dave, PharmD, PhD;
Rutgers University, New Brunswick, NJ, USA
Rutgers University, New Brunswick, NJ, USA
OBJECTIVES: This study aims to evaluate the association between the magnitude of improvements in Patient-Reported Outcomes (PROs) in pivotal clinical trials and their influence on the final incremental cost-effectiveness ratios, and value-based price recommendations for Rheumatoid Arthritis (RA) therapies in the Institute for Clinical and Economic Review (ICER) reports.
METHODS: A correlation analysis was conducted to determine the association between the cost per quality-adjusted life year (QALY) and changes in patient-reported outcomes. Drugs included in ICER’s evidence reports on RA, including TNFα, IL-6, and JAK inhibitors, were identified, with PRO data extracted from pivotal trials and ICER reports. Baseline-to-follow-up changes in patient-reported outcomes, including pain, global patient assessment, and health assessment questionnaire-disease index (HAQ-DI), were extracted from clinical studies and included in the correlation analysis.
RESULTS: Analysis of 12 RA interventions across 5 classes found a significant inverse association between ACR response rates and HAQ-DI (ρ = -0.553, p-value = 0.032). Greater improvements in HAQ-DI were associated with lower incremental cost per QALY, indicating improved cost-effectiveness with increasing quality-of-life gains. In contrast, changes in pain and patient global assessment showed weaker or inconsistent associations. The disability index was observed to have the strongest correlation with cost per quality-adjusted life year (QALY) and average clinical response (ACR), suggesting that this specific measure may be a significant indicator of both patient clinical response and quality of life. However, the extent to which HAQ-DI influenced cost-effectiveness and value-based price recommendations varied depending on the availability of evidence and the selection of comparators.
CONCLUSIONS: Improvements in PROs were more strongly associated with ICER cost-effectiveness estimates than others, such as pain or global assessments. These findings suggest that ICER’s economic evaluations implicitly prioritize disability-related outcomes, highlighting the need for deliberate integration of relevant PRO evidence to inform value-based price recommendations.
METHODS: A correlation analysis was conducted to determine the association between the cost per quality-adjusted life year (QALY) and changes in patient-reported outcomes. Drugs included in ICER’s evidence reports on RA, including TNFα, IL-6, and JAK inhibitors, were identified, with PRO data extracted from pivotal trials and ICER reports. Baseline-to-follow-up changes in patient-reported outcomes, including pain, global patient assessment, and health assessment questionnaire-disease index (HAQ-DI), were extracted from clinical studies and included in the correlation analysis.
RESULTS: Analysis of 12 RA interventions across 5 classes found a significant inverse association between ACR response rates and HAQ-DI (ρ = -0.553, p-value = 0.032). Greater improvements in HAQ-DI were associated with lower incremental cost per QALY, indicating improved cost-effectiveness with increasing quality-of-life gains. In contrast, changes in pain and patient global assessment showed weaker or inconsistent associations. The disability index was observed to have the strongest correlation with cost per quality-adjusted life year (QALY) and average clinical response (ACR), suggesting that this specific measure may be a significant indicator of both patient clinical response and quality of life. However, the extent to which HAQ-DI influenced cost-effectiveness and value-based price recommendations varied depending on the availability of evidence and the selection of comparators.
CONCLUSIONS: Improvements in PROs were more strongly associated with ICER cost-effectiveness estimates than others, such as pain or global assessments. These findings suggest that ICER’s economic evaluations implicitly prioritize disability-related outcomes, highlighting the need for deliberate integration of relevant PRO evidence to inform value-based price recommendations.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
PT33
Topic
Patient-Centered Research
Topic Subcategory
Patient-reported Outcomes & Quality of Life Outcomes
Disease
SDC: Musculoskeletal Disorders (Arthritis, Bone Disorders, Osteoporosis, Other Musculoskeletal)