Cost-effectiveness of tocilizumab, a humanized anti-interleukin-6 receptor monoclonal antibody, versus methotrexate in patients with rheumatoid arthritis using real-world data from the IORRA observational cohort study.

Abstract

OBJECTIVES:

To evaluate the cost-effectiveness of tocilizumab in patients with rheumatoid arthritis (RA) in a real-world setting in Japan.

METHODS:

The cost-effectiveness was determined using a Markov model-based probabilistic simulation. Data from RA patients registered in the Institute of Rheumatology, Rheumatoid Arthritis (IORRA) cohort study between April 2007 and April 2011 were extracted using a pair-matching method: tocilizumab group (n = 104), patients who used at least 1 disease-modifying anti- rheumatic drug and in whom tocilizumab treatment was initiated; methotrexate group (n = 104), patients in whom methotrexate treatment was initiated for the first time or after an interruption of 6 or more months. Assuming a 6-month cycle length, health benefits and costs were measured over a lifetime and discounted at an annual rate of 3%.

RESULTS:

Compared with methotrexate treatment, lifetime costs and quality-adjusted life years (QALYs) for tocilizumab treatment were approximately 1.5- and 1.3-times higher, respectively. Incremental cost per QALY gained with tocilizumab was $49,359, which was below the assumed cost-effectiveness threshold of $50,000 per QALY. The probability of tocilizumab being cost- effective was 62.2%.

CONCLUSION:

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.

• Authors: Eiichi Tanaka, Eisuke Inoue, Daisuke Hoshi, Yoko Shimizu, Akiko Kobayashi, Naoki Sugimoto, Kumi Shidara, Eri Sato, Yohei Seto, Ayako Nakajima, Shigeki Momohara, Atsuo Taniguchi, Hisashi Yamanaka
• Journal: Modern rheumatology (Mod Rheumatol) Vol. 25 Issue 4 Pg. 503-13 (Jul 2015) ISSN: 1439-7609 [Electronic] England
• PMID: 25547018 (Publication Type: Journal Article, Multicenter Study, Observational Study, Research Support, Non-U.S. Gov't)

Chemical References

• Antibodies, Monoclonal, Humanized
• Antirheumatic Agents
• Receptors, Interleukin-6
• tocilizumab
• Methotrexate

Topics

• Aged
• Antibodies, Monoclonal, Humanized (economics, therapeutic use)
• Antirheumatic Agents (economics, therapeutic use)
• Arthritis, Rheumatoid (drug therapy, economics)
• Cohort Studies
• Cost-Benefit Analysis
• Health Care Costs (trends)
• Humans
• Japan
• Male
• Methotrexate (economics, therapeutic use)
• Middle Aged
• Quality of Life
• Quality-Adjusted Life Years
• Receptors, Interleukin-6 (antagonists & inhibitors, immunology)
• Treatment Outcome