PMID- 32346301
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220414
IS  - 1178-6981 (Print)
IS  - 1178-6981 (Electronic)
IS  - 1178-6981 (Linking)
VI  - 12
DP  - 2020
TI  - Cost-Effectiveness of a JAK1/JAK2 Inhibitor vs a Biologic Disease-Modifying 
      Antirheumatic Drug (bDMARD) in a Treat-to-Target Strategy for Rheumatoid 
      Arthritis.
PG  - 213-222
LID - 10.2147/CEOR.S231558 [doi]
AB  - BACKGROUND: Baricitinib is a janus kinase (JAK1/JAK2) inhibitor developed for the 
      treatment of patients suffering from rheumatoid arthritis (RA). Treating RA to 
      the target of remission is current common practice. Cost-effectiveness of 
      different treat-to-target (T2T) strategies, especially ones including new 
      treatments is important for development and preference policy for treatment 
      centers. European League Against Rheumatism (EULAR) and American College of 
      Rheumatology (ACR) guidelines are currently unclear about preference between a 
      JAK1/JAK2 versus a biological disease-modifying antirheumatic drug (bDMARD). 
      OBJECTIVE: The main goal of this paper was to evaluate the cost-effectiveness of 
      baricitinib versus first biological for methotrexate inadequate responders in a 
      T2T strategy using a Markov model that incorporates hospital costs as well as 
      societal costs. Costs and utilities over five years were compared between the two 
      strategies. METHODS: A Monte Carlo simulation model was developed to conduct 
      cost-utility analysis from the societal perspective over 5 years. Health states 
      were based on the DAS28-erythrocyte sedimentation rate (ESR) categories. 
      Effectiveness of baricitinib was retrieved from randomized controlled trials. 
      Effectiveness of all other treatments, health state utilities, medical costs, and 
      productivity loss were retrieved from the Dutch RhEumatoid Arthritis Monitoring 
      (DREAM) cohorts. Annual discount rates of 1.5% for utility and 4% for costs were 
      used. Probabilistic sensitivity analysis was employed to incorporate uncertainty 
      and assess robustness of the results. RESULTS: Probabilistic sensitivity analysis 
      results showed the baricitinib strategy yielded lower costs and higher utility 
      over a 5-year period. Scenario analyses showed the baricitinib strategy to be 
      cost-effective in both the moderate and severe RA populations. CONCLUSION: 
      Results suggest that the use of a JAK1/JAK2 inhibitor instead of a bDMARD in a 
      T2T approach is cost-effective in csDMARD refractory RA patients.
CI  - (c) 2020 Van De Laar et al.
FAU - Van De Laar, Celine J
AU  - Van De Laar CJ
AUID- ORCID: 0000-0002-9859-1034
AD  - Transparency in Healthcare BV, Hengelo, the Netherlands.
FAU - Oude Voshaar, Martijn A H
AU  - Oude Voshaar MAH
AD  - Transparency in Healthcare BV, Hengelo, the Netherlands.
AD  - Department of Psychology and Communication of Health and Risk, Institute for 
      Behavioural Research, University of Twente, Enschede, the Netherlands.
FAU - Fakhouri, Walid K H
AU  - Fakhouri WKH
AD  - Eli Lilly & Company, Indianapolis, IN, USA.
FAU - Zaremba-Pechmann, Liliana
AU  - Zaremba-Pechmann L
AD  - Eli Lilly & Company, Indianapolis, IN, USA.
FAU - De Leonardis, Francesco
AU  - De Leonardis F
AD  - Eli Lilly & Company, Indianapolis, IN, USA.
FAU - De La Torre, Inmaculada
AU  - De La Torre I
AD  - Eli Lilly & Company, Indianapolis, IN, USA.
FAU - Van De Laar, Mart A F J
AU  - Van De Laar MAFJ
AD  - Transparency in Healthcare BV, Hengelo, the Netherlands.
AD  - Department of Psychology and Communication of Health and Risk, Institute for 
      Behavioural Research, University of Twente, Enschede, the Netherlands.
LA  - eng
PT  - Journal Article
DEP - 20200415
PL  - New Zealand
TA  - Clinicoecon Outcomes Res
JT  - ClinicoEconomics and outcomes research : CEOR
JID - 101560564
PMC - PMC7167259
OTO - NOTNLM
OT  - Markov model
OT  - baricitinib
OT  - cost-effectiveness
OT  - health economic model
OT  - treat-to-target
OT  - rheumatoid arthritis
COIS- C Van De Laar, MAH Oude Voshaar, and MAF Van De Laar received a grant from Eli 
      Lilly & Company to perform the health economic analysis in this study. MAF Van De 
      Laar reports personal fees from Eli Lilly during the conduct of the study. L 
      Zaremba-Pechmann is a contractor at Lilly Deutschland GmbH through HaaPACS GmbH. 
      F De Leonardis, I De La Torre, and WKH Fakhouri are employees at Eli Lilly & 
      Company and stockholders. The authors report no other conflicts of interest in 
      this work.
EDAT- 2020/04/30 06:00
MHDA- 2020/04/30 06:01
PMCR- 2020/04/15
CRDT- 2020/04/30 06:00
PHST- 2019/09/18 00:00 [received]
PHST- 2020/02/25 00:00 [accepted]
PHST- 2020/04/30 06:00 [entrez]
PHST- 2020/04/30 06:00 [pubmed]
PHST- 2020/04/30 06:01 [medline]
PHST- 2020/04/15 00:00 [pmc-release]
AID - 231558 [pii]
AID - 10.2147/CEOR.S231558 [doi]
PST - epublish
SO  - Clinicoecon Outcomes Res. 2020 Apr 15;12:213-222. doi: 10.2147/CEOR.S231558. 
      eCollection 2020.