PharmacoEconomics & Outcomes News 537 - 22 Sep 20071. Botteman MF, et al. Cost effectiveness of adalimumab for the treatment ofCost effective treatment options for ankylosing spondylitis in the United Kingdom. Rheumatology 46: 1320-1328,

No. 8, Aug 2007.AS2. Ara RM, et al. The cost-effectiveness of etanercept in patients with severe

ankylosing spondylitis in the UK. Rheumatology 46: 1338-1344, No. 8, AugAdalimumab and etanercept are cost effective for the 2007.

801069930treatment of patients with ankylosing spondylitis (AS),according to the results of two studies conducted fromthe perspective of the UK NHS.1,2

Adalimumab of benefit for ASResearchers from the US and The Netherlands

conducted a cost effectiveness analysis to evaluate theuse of adalimumab versus conventional therapy amongpatients with AS.1 The analysis was conducted over 1-,5- and 30-year time horizons; costs* and outcomes werediscounted at 3.5% per annum.

In the base-case analysis, adalimumab would be costeffective for the treatment of AS; moreover, theestimated cost effectiveness improved as the timehorizon increased [see table 1].

Table 1. Cost effectiveness of adalimumab vsconventional therapy for AS

Adalimumab vs conventional therapy

1 year 5 years 30 years(48 weeks)

Difference in outcomes:QALY +0.1067 +0.5041 +1.0329Total cost (£)* +5025 +13 273 +23 857ICER** 47 083 26 332 23 097

* 2004 values** incremental cost-effectiveness ratio; cost/QALY gained

Etanercept also good valueIn another study, researchers from the UK developed

a cost effectiveness model to assess the costeffectiveness of etanercept plus NSAIDs versus NSAIDsalone for the treatment of AS.2 The analysis wasconducted over a 25-year time horizon among a cohortof 1000 hypothetical patients with AS; costs** andoutcomes were discounted at 3.5% per annum.

At 2 years, etanercept would be cost effective for thetreatment of AS; moreover, etanercept would becomemore cost effective over time [see table 2]

Table 2. Cost effectiveness of etanercept + NSAIDsvs NSAIDs for AS

Etanercept vs NSAID therapy

2 years 5 years 15 years 25 years

Discounted incremental outcome:QALYs +368 +815 +1453 +1585Costs 10 152 034 19 280 748 32 818 855 35 978 245(£)

ICER* 27 594 23 649 22 580 22 704

* cost/QALY gained

* Costs (2004 values) included those associated with specialist visits,TB testing, X-ray, monthly safety monitoring, medication, and cost ofadverse events.** including medication, hospitalisation and physiotherapy costs

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PharmacoEconomics & Outcomes News 22 Sep 2007 No. 5371173-5503/10/0537-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved