Economic Evaluation of Biologic Drugs Used to Treat Thai Ankylosing Spondylitis Patients

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Published: Oct 17, 2022
DOI: https://doi.org/10.14456/ijps.2022.14
Keywords:
Ankylosing Spondylitis, biological agents, cost-utility analysis, economic evaluation

Main Article Content

Sikkawat Nakrong
Department of Pharmacy Administration, College of Pharmacy, Rangsit University, Muang, Pathum Thani 12000 Thailand
Pin Angvitit
Department of Pharmacy Administration, College of Pharmacy, Rangsit University, Muang, Pathum Thani 12000 Thailand
Angkana Kimlek
Department of Pharmacy Administration, College of Pharmacy, Rangsit University, Muang, Pathum Thani 12000 Thailand
Pagamas Maitreemit
Department of Pharmacy Administration, College of Pharmacy, Rangsit University, Muang, Pathum Thani 12000 Thailand
Surachai Kotirum
Department of Pharmacy Administration, College of Pharmacy, Rangsit University

Abstract

Objective: To assess the cost-effectiveness and budget impact of 4 biologic drugs including etanercept, golimumab, infliximab, and secukinumab under their treatment indication for Thai Ankylosing Spondylitis (AS) patients. Methods: Economic evaluation using based on cost-utility analysis approach combining a by adopting decision tree model combined with and a Markov model to simulate the disease progression in among AS patients over their life expectancy. Model was calculated in Microsoft Excel computer program and used to analyze both cost and benefit outcomes by comparing the biological agents as a new alternative after non-steroidal anti-inflammatory drugs (NSAIDs) and disease modifying anti-rheumatic drugs (DMARDs) failure with standard option. Analysis results were presented in the form of the incremental cost-effectiveness ratio (ICER) in terms of baht/quality-adjusted life years (QALY) gained. Results: Under a societal perspective, secukinumab biosimilar (ScaphoÒ), infliximab biosimilar (RemsimaÒ), etanercept (ScaphoÒ), infliximab biosimilar (RemsimaÒ), secukinumab original (CosentyxÒ), infliximab original (RemicadeÒ), and golimumab (SymponiÒ) provided the ICERs compared with standard treatment as follows: 217,237; 285,902; 434,816; 438,755; 471,172 and 502,557 baht/QALY gained, respectively. The 5-year budget impact from the administration of secukinumab biosimilar to Thai AS patients is 252 million baht. Conclusion: At the current price of the analyzed 4 biological drugs (6 brands), no biological drug offers a good value for money under the Thai context when considering against the willingness-to-pay of 160,000 baht/QALY gained as the cost-effectiveness threshold. However, decision making to include a biologic drug for this patient group to the national essential drug list can additionally consider social and ethical aspects of health technology assessment.

Article Details

Issue
Vol. 18 No. 3 (2022): Volume 18 No.3, July – September 2022
Section
Pharmaceutical Practice
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