COST-UTILITY ANALYSIS OF RISANKIZUMAB VERSUS USTEKINUMAB FOR THE TREATMENT OF BIOLOGIC-FAILED CROHN'S DISEASE IN CHINA
Author(s)
Peisong Dong, MA, Xiaoning He, PhD.
School of Pharmaceutical Science and Technology, Tianjin University, Tianjin, China.
School of Pharmaceutical Science and Technology, Tianjin University, Tianjin, China.
OBJECTIVES: To evaluate the cost-effectiveness of Risankizumab (RZB) compared with Ustekinumab (UST) for adults with moderate-to-severe (MS) active Crohn's disease (CD) who have failed biologic therapy from the Chinese healthcare system perspective.
METHODS: A decision tree combined with a Markov model (2-week cycle, lifetime horizon) was developed. Clinical efficacy data, including induction response/remission and maintenance remission, were sourced from the head-to-head Phase III SEQUENCE trial (NCT04524611). The endoscopic response rate was obtained from Network Meta Analysis. Health state utilities were derived from IBDQ scores collected during the trial and mapped to EQ-5D. Costs included biologic acquisition and administration, health state management, surgeries, and adverse events. The robustness of the base-case findings was further evaluated through scenario analyses, incorporating a truncated 10-year time horizon and a conservative assumption excluding long term health gains from endoscopic response.
RESULTS: In the base-case (lifetime horizon), RZB was associated with an incremental benefit of 0.971 QALYs and an incremental cost of ¥23,689 compared to UST. This resulted in an ICER of ¥24,715/QALY (€3,169/QALY), which is well below the threshold of 1x GDP per capita in China. Notably, RZB demonstrated economic competitiveness even within a relatively short horizon (ICER: ¥97,776/QALY; €12,535/QALY). Furthermore, its cost-effective advantage remained robust under conservative assumptions, yielding an ICER of ¥51,705/QALY (€6,629/QALY) even when excluding endoscopic response benefits. Deterministic Sensitivity Analysis revealed that the ICER was most sensitive to the ordered probit regression parameters for conventional treatment transitions, the maintenance remission rate for UST, and the health-state maintenance costs for MS CD. Probabilistic sensitivity analysis confirmed that RZB had a >90% probability of being cost-effective at standard thresholds.
CONCLUSIONS: From the Chinese healthcare system perspective, RZB is highly cost-effective compared to UST for patients with biologic-failed MS CD.
METHODS: A decision tree combined with a Markov model (2-week cycle, lifetime horizon) was developed. Clinical efficacy data, including induction response/remission and maintenance remission, were sourced from the head-to-head Phase III SEQUENCE trial (NCT04524611). The endoscopic response rate was obtained from Network Meta Analysis. Health state utilities were derived from IBDQ scores collected during the trial and mapped to EQ-5D. Costs included biologic acquisition and administration, health state management, surgeries, and adverse events. The robustness of the base-case findings was further evaluated through scenario analyses, incorporating a truncated 10-year time horizon and a conservative assumption excluding long term health gains from endoscopic response.
RESULTS: In the base-case (lifetime horizon), RZB was associated with an incremental benefit of 0.971 QALYs and an incremental cost of ¥23,689 compared to UST. This resulted in an ICER of ¥24,715/QALY (€3,169/QALY), which is well below the threshold of 1x GDP per capita in China. Notably, RZB demonstrated economic competitiveness even within a relatively short horizon (ICER: ¥97,776/QALY; €12,535/QALY). Furthermore, its cost-effective advantage remained robust under conservative assumptions, yielding an ICER of ¥51,705/QALY (€6,629/QALY) even when excluding endoscopic response benefits. Deterministic Sensitivity Analysis revealed that the ICER was most sensitive to the ordered probit regression parameters for conventional treatment transitions, the maintenance remission rate for UST, and the health-state maintenance costs for MS CD. Probabilistic sensitivity analysis confirmed that RZB had a >90% probability of being cost-effective at standard thresholds.
CONCLUSIONS: From the Chinese healthcare system perspective, RZB is highly cost-effective compared to UST for patients with biologic-failed MS CD.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE337
Topic
Economic Evaluation, Health Policy & Regulatory, Health Technology Assessment
Topic Subcategory
Trial-Based Economic Evaluation
Disease
Biologics & Biosimilars, Gastrointestinal Disorders