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VBCR - April 2015, Volume 4, No 2 - Value Propositions

In an earlier study, Tanaka and colleagues found that cost-effectiveness appears to favor tocilizumab (TCZ), a humanized anti-interleukin-6 receptor monoclonal antibody, in comparison with TNF inhibitors in patients with rheumatoid arthritis (RA). (Biologics; 2014). A more recent study was designed to evaluate the cost-effectiveness of TCZ versus methotrexate (MTX) in patients with RA. Researchers used a Markov model­–based probabilistic simulation and data from the Institute of Rheumatology, Rheumatoid Arthritis (IORRA) observational cohort study to measure cost-effectiveness in a real-world setting in Japan. Data were derived from records of patients with RA who were registered in the IORRA cohort study between April 2007 and April 2011.

The TCZ group (n = 104) comprised patients who used at least 1 disease-modifying antirheumatic drug and in whom TCZ treatment was initiated; the MTX group (n = 104) comprised patients in whom MTX treatment was used either for the first time or after an interruption of at least 6 months. Based on a 6-month cycle, health benefits and costs were measured over a lifetime and discounted at an annual rate of 3%. TCZ treatment had lifetime costs and quality-adjusted life years (QALYs) that were higher than those of treatment with MTX. In the TCZ group, the lifetime cumulative costs and QALYs were ¥35.4 million [$297,691.63] and 11.7 years, respectively, and in the MTX group, they were ¥23.3 million [$195,938.27] and 9.3 years, respectively. The incremental cost per QALY gained was $49,359 with TCZ, slightly lower than the cost-effectiveness threshold of $50,000 per QALY. The probability of TCZ being cost-effective was 62.2%.

The authors concluded that the simulation model using real-world data from Japan showed that tocilizumab (at a certain price) may improve treatment cost-effectiveness in patients with moderate-to-severe RA by enhancing quality-adjusted life expectancy. Tanaka E. Mod Rheumatol. Published online: February 11, 2015.

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Last modified: May 21, 2015
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