Author(s)
Laires PA1, Mourão AF2, Ribeiro C3, Borges J4, Gonçalves MJ5, Bernardes JM6, Fernandes S4, Dezerto R1, Eusébio M7, Santos MJ8, Canhão H7
1Merck Sharp & Dohme, Oeiras, Portugal, 2Hospital de Egas Moniz (Centro Hospitalar de Lisboa Ocidental), Lisbon, Portugal, 3Hospital de Faro (Centro Hospitalar do Algarve), Faro, Portugal, 4IPR - Instituto Português de Reumatologia, Lisbon, Portugal, 5Hospital de Santa Maria - Centro Hospitalar Lisboa Norte, Lisbon, Portugal, 6Centro Hospitalar De São João, E.P.E., Porto, Portugal, 7Sociedade Portuguesa de Reumatologia, Lisbon, Portugal, 8Hospital Garcia de Orta, Almada, Portugal
OBJECTIVES: We aimed to measure QALY gains following 1 year of golimumab treatment in Portuguese RA patients in a real-world setting and calculated the number needed per QALY gained (NNQ). METHODS: Data were collected from the national RA registry (Reuma.Pt) for all registered biologic-naïve patients aged >18 years diagnosed with active RA who started and remained on golimumab combined with methotrexate for at least 52 weeks (Study period: March 2011 – August 2015). QALY values were calculated through the sum of each patient EQ-5D utility value [derived from the health assessment questionnaire disability index (HAQ) scores by applying a validated algorithm: EQ-5D = 0.9567 – (0.306 x HAQ)] multiplied by the corresponding follow-up time. The NNQ (i.e. the number of patients one has to treat in order to gain 1 QALY) was calculated as the inverted value of the utility gain over 1 year. RESULTS: From the 54 subjects with at least 52 weeks of treatment with the information regarding HAQ, 19 (35.2%) achieved functional remission (i.e. HAQ<0.5). 88.9% were women, with mean age 56.6 (SD 12.1) years, disease duration 9.0 (SD 7.3) years, mean DAS28 3.3 (SD 1.2), HAQ score 0.9 (SD 0.7), and EQ-5D utility score 0.7 (SD 0.2). We observed significant gains in the quality of life and 81.3% of patients gained QALY. The mean QALY gain was 0.16 per patient and the NNQ was 6.25. Based on these data we estimated an incremental cost-effectiveness ratio of less than previously published figures (i.e. <60,000 €/QALY). However, this analysis was limited by a short time horizon and limited cost data available (e.g. productivity gains were not included). CONCLUSIONS: In this real-world study we observed a significant functional remission and an improvement on the quality of life of RA patients treated with golimumab in Portugal. Furthermore, the vast majority of patients gained QALY.
Conference/Value in Health Info
2016-10, ISPOR Europe 2016, Vienna, Austria
Value in Health, Vol. 19, No. 7 (November 2016)
Code
PMS3
Topic
Clinical Outcomes
Topic Subcategory
Comparative Effectiveness or Efficacy
Disease
Musculoskeletal Disorders