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A Systematic Review of the Cost-Effectiveness of Biologics for the Treatment of Inflammatory Bowel Diseases

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  • Saara Huoponen
  • Marja Blom

Abstract

Background: Biologics are used for the treatment of inflammatory bowel diseases, Crohn´s disease and ulcerative colitis refractory to conventional treatment. In order to allocate healthcare spending efficiently, costly biologics for inflammatory bowel diseases are an important target for cost-effectiveness analyses. The aim of this study was to systemically review all published literature on the cost-effectiveness of biologics for inflammatory bowel diseases and to evaluate the methodological quality of cost-effectiveness analyses. Methods: A literature search was performed using Medline (Ovid), Cochrane Library, and SCOPUS. All cost-utility analyses comparing biologics with conventional medical treatment, another biologic treatment, placebo, or surgery for the treatment of inflammatory bowel diseases in adults were included in this review. All costs were converted to the 2014 euro. The methodological quality of the included studies was assessed by Drummond’s, Philips’, and the Consolidated Health Economic Evaluation Reporting Standards checklist. Results: Altogether, 25 studies were included in the review. Among the patients refractory to conventional medical treatment, the incremental cost-effectiveness ratio ranged from dominance to 549,335 €/Quality-Adjusted Life Year compared to the incremental cost-effectiveness ratio associated with conventional medical treatment. When comparing biologics with another biologic treatment, the incremental cost-effectiveness ratio ranged from dominance to 24,012,483 €/Quality-Adjusted Life Year. A study including both direct and indirect costs produced more favorable incremental cost-effectiveness ratios than those produced by studies including only direct costs. Conclusions: With a threshold of 35,000 €/Quality-Adjusted Life Year, biologics seem to be cost-effective for the induction treatment of active and severe inflammatory bowel disease. Between biologics, the cost-effectiveness remains unclear.

Suggested Citation

  • Saara Huoponen & Marja Blom, 2015. "A Systematic Review of the Cost-Effectiveness of Biologics for the Treatment of Inflammatory Bowel Diseases," PLOS ONE, Public Library of Science, vol. 10(12), pages 1-23, December.
    • Handle: RePEc:plo:pone00:0145087
    DOI: 10.1371/journal.pone.0145087
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    References listed on IDEAS

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    1. Don Husereau & Michael Drummond & Stavros Petrou & Chris Carswell & David Moher & Dan Greenberg & Federico Augustovski & Andrew Briggs & Josephine Mauskopf & Elizabeth Loder, 2013. "Consolidated Health Economic Evaluation Reporting Standards (CHEERS) Statement," PharmacoEconomics, Springer, vol. 31(5), pages 361-367, May.
    2. Yogesh Punekar & Neil Hawkins, 2010. "Cost-effectiveness of infliximab for the treatment of acute exacerbations of ulcerative colitis," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 11(1), pages 67-76, February.
    3. Drummond, Michael F. & Sculpher, Mark J. & Torrance, George W. & O'Brien, Bernie J. & Stoddart, Greg L., 2005. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 3, number 9780198529453.
    4. Andrew Yu & Scott Johnson & Si-Tien Wang & Pavel Atanasov & Jackson Tang & Eric Wu & Jingdong Chao & Parvez Mulani, 2009. "Cost Utility of Adalimumab versus Infliximab Maintenance Therapies in the United States for Moderately to Severely Active Crohn’s Disease," PharmacoEconomics, Springer, vol. 27(7), pages 609-621, July.
    5. Ruxi Lv & Weiguang Qiao & Zhiyong Wu & Yinjun Wang & Shixue Dai & Qiang Liu & Xuebao Zheng, 2014. "Tumor Necrosis Factor Alpha Blocking Agents as Treatment for Ulcerative Colitis Intolerant or Refractory to Conventional Medical Therapy: A Meta-Analysis," PLOS ONE, Public Library of Science, vol. 9(1), pages 1-9, January.
    6. Takeru Shiroiwa & Yoon‐Kyoung Sung & Takashi Fukuda & Hui‐Chu Lang & Sang‐Cheol Bae & Kiichiro Tsutani, 2010. "International survey on willingness‐to‐pay (WTP) for one additional QALY gained: what is the threshold of cost effectiveness?," Health Economics, John Wiley & Sons, Ltd., vol. 19(4), pages 422-437, April.
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    1. Nadia Pillai & Mark Dusheiko & Bernard Burnand & Valérie Pittet, 2017. "A systematic review of cost-effectiveness studies comparing conventional, biological and surgical interventions for inflammatory bowel disease," PLOS ONE, Public Library of Science, vol. 12(10), pages 1-22, October.

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