Modeled Health Economic Impact of a Hypothetical Certolizumab Pegol Risk-Sharing Scheme for Patients with Moderate-to-Severe Rheumatoid Arthritis in Finland.
PURPOSE
To model the American College of Rheumatology (ACR) outcomes, cost-effectiveness, and budget impact of certolizumab pegol (CZP) (with and without a hypothetical risk-sharing scheme at treatment initiation for biologic-naïve patients) versus the current mix of reimbursed biologics for treatment of moderate-to-severe rheumatoid arthritis (RA) in Finland.


METHODS
A probabilistic model with 12-week cycles and a societal approach was developed for the years 2015-2019, accounting for differences in ACR responses (meta-analysis), mortality, and persistence. The risk-sharing scheme included a treatment switch and refund of the costs associated with CZP acquisition if patients failed to achieve ACR20 response at week 12. For the current treatment mix, ACR20 at week 24 determined treatment continuation. Quality-adjusted life years were derived on the basis of the Health Utilities Index.


RESULTS
In the Finnish target population, CZP treatment with a risk-sharing scheme led to a estimated annual net expenditure decrease ranging from 1.7% in 2015 to 5.6% in 2019 compared with the current treatment mix. Per patient over the 5 years, CZP risk sharing was estimated to decrease the time without ACR response by 5%-units, decrease work absenteeism by 24 days, and increase the time with ACR20, ACR50, and ACR70 responses by 5%-, 6%-, and 1%-units, respectively, with a gain of 0.03 quality-adjusted life years. The modeled risk-sharing scheme showed reduced costs of €7866 per patient, with a more than 95% probability of cost-effectiveness when compared with the current treatment mix.


CONCLUSION
The present analysis estimated that CZP, with or without the risk-sharing scheme, is a cost-effective alternative treatment for RA patients in Finland. The surplus provided by the CZP risk-sharing scheme could fund treatment for 6% more Finnish RA patients.


FUNDING
UCB Pharma.
['Soini|Erkki|E|', 'Asseburg|Christian|C|', 'Taiha|Maarit|M|', 'Puolakka|Kari|K|', 'Purcaru|Oana|O|', 'Luosujärvi|Riitta|R|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D018501:Antirheumatic Agents D001172:Arthritis, Rheumatoid D000068582:Certolizumab Pegol D003362:Cost-Benefit Analysis D005260:Female D005387:Finland D006801:Humans D008297:Male D008875:Middle Aged D011092:Polyethylene Glycols D019057:Quality-Adjusted Life Years D018570:Risk Assessment D016896:Treatment Outcome
Health economics Certolizumab pegol Rheumatoid arthritis Rheumatology Biological therapies Disease-modifying antirheumatic drugs Health policies