EVALUATING THE COST UTILITY OF LICENSED BUDESONIDE FOR EOSINOPHILIC ESOPHAGITIS (EOE) IN SWEDEN
Author(s)
ABSTRACT WITHDRAWN
OBJECTIVES : Until 2018 only off-label treatments were available for EoE. In 2018, a novel orodispersible tablet formulation of budesonide (Jorveza®) was licensed. To evaluate the cost utility of Jorveza® for the treatment of adult EoE versus current (off-label) comparators in the Swedish healthcare setting. METHODS : A bespoke cost utility model was developed according to best practice recommendations for modelling. The model structure is based on international clinical guidelines for EoE. Clinical efficacy parameters were based on a systematic review of all available evidence from RCTs and controlled trials. Efficacy parameters were derived from direct and indirect treatment comparisons (Bucher method) for other formulations of budesonide and fluticasone and from network meta-analysis (Bayesian approach) for six food elimination diet (SFED) and proton pump inhibitors (PPIs). Utility parameters were derived from a systematic review of utility data. Resource use for Sweden was estimated based on expert opinion. Resources were valued using Swedish cost data. Adverse events were derived from the same publications which supplied efficacy data. The base case analysis refers to a societal perspective based on a five-year time horizon and presents results discounted at 3% for costs and health outcomes. Deterministic and probabilistic sensitivity analyses (PSA) were performed. RESULTS : Jorveza® dominates SFED, budesonide oral viscous formulation, PPI and combined treatment with fluticasone and PPI. This means Jorveza® results in both, a cost-reduction and a gain in QALYs relative to those comparators. The incremental cost effectiveness ratio for Jorveza® versus other (off-label) budesonide formulations (e.g. inhaled) is SEK 6‘218 (approx. € 605) /QALY and SEK 257‘076 (approx. € 25‘000) /QALY versus fluticasone. The PSA yielded ICERs at the deterministic result level or lower 70% and 85% of the time for budesonide and fluticasone, respectively. CONCLUSIONS : Jorveza® is cost-effective relative to all (off-label) comparators using common cost effectiveness thresholds.
Conference/Value in Health Info
2019-05, ISPOR 2019, New Orleans, LA, USA
Value in Health, Volume 22, Issue S1 (2019 May)
Code
PGI18
Topic
Clinical Outcomes, Economic Evaluation, Methodological & Statistical Research
Topic Subcategory
Comparative Effectiveness or Efficacy, Cost-comparison, Effectiveness, Utility, Benefit Analysis, Modeling and simulation
Disease
Gastrointestinal Disorders, Rare