A cost-utility analysis of biosimilar infliximab compared to reference infliximab in adult switch patients with Crohn’s disease: a Canadian analysis

Hughes A, Marshall J, Moretti ME, Ungar WJ
Record ID 32018000447
Authors' objectives: The objective is to assess the incremental cost of maintenance treatment for adults with CD who have been switched from reference infliximab to biosimilar infliximab compared with those who have been maintained on reference infliximab per quality adjusted life year (QALY) gained from the healthcare system perspective.
Authors' results and conclusions: In the reference case, total costs for switching to biosimilar infliximab were $50,191 (standard deviation [SD]: $4,771) and 3.06 (SD: 0.38) QALYs. Costs for maintaining treatment with reference infliximab were $96,385 (SD: $6,834) and 3.19 (SD: 0.35) QALYs. The intervention was associated with incremental costs of -$46,194 (95% Confidence Interval [CI]: -$42,420 to -$50,455) and a loss in quality adjusted life-years of -0.13 (95% CI: -0.16 to -0.07). Eighty-three percent of the simulations were in the south-west quadrant with incremental cost savings and an incremental loss of effectiveness. Biosimilar infliximab is associated with incremental savings when CD patients on maintenance therapy are switched from reference infliximab. However, decision makers must also account for an incremental loss of effectiveness with biosimilars in accordance with the NOR-SWITCH subgroup analysis. Further evidence regarding switching to biosimilar treatments for CD patients will be integral as jurisdictions work to develop effective reimbursement policies for biosimilars.
Authors' methods: A probabilistic cohort Markov decision model with eight-week cycle lengths was constructed to estimate the incremental costs and effects of switching to biosimilar infliximab over a five-year time horizon. Clinical inputs were obtained from NOR-SWITCH and other published pivotal trials. Costs were obtained from Canadian sources. A total of 10,000 simulations were run. Sensitivity analysis was used to test the robustness of the results to variations in uncertain parameters.
Project Status: Completed
Year Published: 2019
English language abstract: An English language summary is available
Publication Type: Full HTA
Country: Canada
MeSH Terms
  • Crohn Disease
  • Infliximab
  • Adult
  • Quality-Adjusted Life Years
  • Cost-Benefit Analysis
  • Biosimilar Pharmaceuticals
  • Crohn's disease
  • Cost-utility analysis
  • Infliximab
Organisation Name: Technology Assessment at SickKids
Contact Address: Program of Child Health Evaluative Sciences, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1X8 tel: (416) 813-8519 fax: (416) 813-5979
Contact Name: wendy.ungar@sickkids.ca
Contact Email: wendy.ungar@sickkids.ca
Copyright: Technology Assessment Unit of the Hospital for Sick Children (TASK)
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