OBJECTIVES

: The aim of study was to compare the efficacy and cost of treatment by adalimumab and golimumab in patients with ulcerative colitis, according to National clinical guidelines of Kazakhstan.

METHODS

: The search and analysis of the randomized controlled trials and systematic reviews on the efficacy of golimumab and adalimumab compared with placebo was performed in the databases MEDLINE, Cochrane Library (1990-2017). The primary outcome was index of quality life (IBDQ). 26 RCT and 1 systematic review total was found.

Then the analysis of "cost of illness" was conducted. The cost of drugs was taken according to the marginal price set by the Ministry of Health of Kazakhstan. The scheme of therapy was according to the National Guidelines for treatment of ulcerative colitis, revised on 2017.

RESULTS

: Following the analyses of found published data the higher mean indices of IBDQ were significant in patients with adalimumab vs placebo for 8 weeks (MD 9 (IBDQ on 9 points higher), 95%CI [2.65-15.35] and for 52 weeks (MD 8 (IBDQ is higher on 8 points), 95%CI [0.68-15.32]. For patients who received golimumab at dose of 200/100 mg -MD 12.20 (IBDQ on 12.2 points higher), 95%CI [6.52-17.88]; at dose of 400/200 mg-MD 12.10 (IBDQ on 12.1 points higher), 95%CI [6.40-17.80]. Analysis of cost-effectiveness was not conducted, since there was not enough published data.

The cost of treatment with adalimumab was 5042$ and course of treatment with the drug golimumab was 6404$.

CONCLUSIONS

: The higher indicators of life quality were in therapy with golimumab. The results of "cost of illness" analysis suggest that the scheme of therapy with adalimumab was benefit. As National clinical guideline of ulcerative colitis treatment includes both drugs, the appropriate pharmacoeconomic analysis and health technology assessment in the treatment by expensive drugs should be conducted on a regular basis to ensure the optimal drugs choice