論文

査読有り
2013年3月

Economic impact of combination therapy with infliximab plus azathioprine for drug-refractory Crohn's disease: A cost-effectiveness analysis

JOURNAL OF CROHNS & COLITIS
  • Shota Saito
  • ,
  • Utako Shimizu
  • ,
  • Zhang Nan
  • ,
  • Nozomu Mandai
  • ,
  • Junji Yokoyama
  • ,
  • Kenshi Terajima
  • ,
  • Kouhei Akazawa

7
2
開始ページ
167
終了ページ
174
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1016/j.crohns.2012.04.007
出版者・発行元
ELSEVIER SCIENCE BV

Background: Combination therapy with infliximab (IFX) and azathioprine (AZA) is significantly more effective for treatment of active Crohn's disease (CD) than IFX monotherapy. However, AZA is associated with an increased risk of lymphoma in patients with inflammatory bowel disease.
Aim: To evaluate the cost-effectiveness of combination therapy with IFX plus AZA for drug-refractory CD.
Methods: A decision analysis model is constructed to compare, over a time horizon of 1 year, the cost-effectiveness of combination therapy with IFX plus AZA and that of IFX monotherapy for CD patients refractory to conventional non-anti-TNF-alpha therapy. The treatment efficacy, adverse effects, quality-of-life scores, and treatment costs are derived from published data. One-way and probabilistic sensitivity analyses are performed to estimate the uncertainty in the results.
Results: The incremental cost-effectiveness ratio (ICER) of combination therapy with IFX plus AZA is 24,917 GBP/QALY when compared with IFX monotherapy. The sensitivity analyses reveal that the utility score of nonresponding active disease has the strongest influence on the cost-effectiveness, with ICERs ranging from 17,147 to 45,564 GBP/QALY. Assuming that policy makers are willing to pay 30,000 GBP/QALY, the probability that combination therapy with IFX plus AZA is cost-effective is 0.750.
Conclusions: Combination therapy with IFX plus AZA appears to be a cost-effective treatment for drug-refractory CD when compared with IFX monotherapy. Furthermore, the additional lymphoma risk of combination therapy has little significance on its cost-effectiveness. (C) 2012 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.

リンク情報
DOI
https://doi.org/10.1016/j.crohns.2012.04.007
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/22626508
Web of Science
https://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=JSTA_CEL&SrcApp=J_Gate_JST&DestLinkType=FullRecord&KeyUT=WOS:000314901400011&DestApp=WOS_CPL
ID情報
  • DOI : 10.1016/j.crohns.2012.04.007
  • ISSN : 1873-9946
  • eISSN : 1876-4479
  • PubMed ID : 22626508
  • Web of Science ID : WOS:000314901400011

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