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

URL for published report: https://lab.research.sickkids.ca/task/wp-content/uploads/sites/66/2019/02/CUA_Biosimilar_Infliximab_CD_FULLREPORT_2019-02.pdf

English language abstract: An English language summary is available

Publication Type: Full HTA

Country: Canada

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)