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Consensus Decision Models for Biologics in Rheumatoid and Psoriatic Arthritis: Recommendations of a Multidisciplinary Working Party

Published on Dec 1, 2015
· DOI :10.1007/s40744-015-0020-0
Jason Madan18
Estimated H-index: 18
(UoB: University of Bristol),
Tony Ades5
Estimated H-index: 5
(UoB: University of Bristol)
+ 9 AuthorsAllan Wailoo28
Estimated H-index: 28
(University of Sheffield)
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Abstract
Introduction Biologic therapies are efficacious but costly. A number of health economic models have been developed to determine the most cost-effective way of using them in the treatment pathway. These models have produced conflicting results, driven by differences in assumptions, model structure, and data, which undermine the credibility of funding decisions based on modeling studies. A Consensus Working Party met to discuss recommendations and approaches for future models of biologic therapies.
  • References (24)
  • Citations (9)
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References24
Newest
Published on Jun 1, 2013in Annals of the Rheumatic Diseases14.30
Philip S Helliwell P S55
Estimated H-index: 55
,
Oliver FitzGerald65
Estimated H-index: 65
(UCD: University College Dublin)
+ 33 AuthorsRobin Waxman12
Estimated H-index: 12
(University of Leeds)
Objective To develop new composite disease activity indices for psoriatic arthritis (PsA). Methods Data from routine clinic visits at multiple centres were collected in a systematic manner. Data included all domains identified as important in randomised controlled trials in PsA. Decisions to change treatment were used as surrogates for high disease activity. New indices were developed by multiple linear regression (psoriatic arthritis disease activity score: PASDAS) and empirically, utilising ph...
Published on Sep 1, 2012in Rheumatology5.15
Maria K. Kvamme5
Estimated H-index: 5
(University of Oslo),
Elisabeth Lie22
Estimated H-index: 22
(University of Oslo)
+ 1 AuthorsIvar Sønbø Kristiansen34
Estimated H-index: 34
(University of Oslo)
Objective. The overall aim of this study was to estimate the total costs for patients with RA, AS and psoriatic arthritis (PsA) treated with DMARDs. Specific aims were to compare the costs across diagnoses and over time. Methods. The main data source was the Norwegian DMARD register (NOR-DMARD) that captures outcomes and resource use among patients starting therapy with synthetic and biologic DMARDs. Costs were estimated for four 6-month periods from the start of a DMARD regimen. We included RA ...
Published on Sep 1, 2011in Rheumatology5.15
Nicky J Welton43
Estimated H-index: 43
(UoB: University of Bristol),
Jason Madan18
Estimated H-index: 18
(UoB: University of Bristol),
Ae Ades58
Estimated H-index: 58
(UoB: University of Bristol)
Reimbursement decisions are typically based on cost-effectiveness analyses. While a cost-effectiveness analysis can identify the optimum strategy, there is usually some degree of uncertainty around this decision. Sources of uncertainty include statistical sampling error in treatment efficacy measures, underlying baseline risk, utility measures and costs, as well as uncertainty in the structure of the model. The optimal strategy is therefore only optimal on average, and a decision to adopt this s...
Published on Sep 1, 2011in Rheumatology5.15
Pelham Barton4
Estimated H-index: 4
(University of Birmingham)
The Birmingham Rheumatoid Arthritis Model (BRAM) has been developed over a number of years to inform several appraisals of biologic drugs by the Technology Appraisals Committee of the UK National Institute for Health and Clinical Excellence. This article describes the processes used in the construction of the different versions of the BRAM.
Published on Sep 1, 2011in Rheumatology5.15
Paresh Jobanputra12
Estimated H-index: 12
(University of Birmingham)
Modelling cost-effectiveness of new drugs for RA has become increasingly prevalent and sophisticated. This situation has arisen largely because regulatory agencies, such as the National Institute for Health and Clinical Excellence, have demanded models from industry and have commissioned independent models. Many technical aspects of health economic models have converged—yet the results of models differ greatly. These differences can be accounted for in large part by differences in assumptions ab...
Published on Sep 1, 2011in Rheumatology5.15
Ae Ades58
Estimated H-index: 58
(UoB: University of Bristol),
Jason Madan18
Estimated H-index: 18
(UoB: University of Bristol),
Nicky J Welton43
Estimated H-index: 43
(UoB: University of Bristol)
Evidence for the efficacy of biologic therapies in inflammatory arthritis comes overwhelmingly from placebo-controlled trials. Increasingly, however, authorities responsible for purchasing and re-imbursement have tried to determine whether there are differences between these powerful new therapies, which would lead them to recommend some in preference to others, either on grounds of efficacy or costeffectiveness. In the absence of head-to-head trial comparisons, indirect comparisons may be used....
Published on Sep 1, 2011in Rheumatology5.15
A J Silman104
Estimated H-index: 104
(Arthritis Research UK)
Published on Sep 1, 2011in Rheumatology5.15
Laura Bojke20
Estimated H-index: 20
(Ebor: University of York),
David Epstein25
Estimated H-index: 25
(Ebor: University of York)
+ 4 AuthorsMark Sculpher74
Estimated H-index: 74
(Ebor: University of York)
Objectives. A probabilistic model was developed to determine the cost-effectiveness of three biologics, etanercept, infliximab and adalimumab, compared with palliative care for the treatment of active and progressive PsA in patients who have an inadequate response to standard treatment (including DMARDs). Methods. A previous model was revised to evaluate the impact of biologics on both skin and joint disease and to include new evidence from the clinical review and evidence synthesis. Initial res...
Published on Sep 1, 2011in Rheumatology5.15
Jonathan Tosh10
Estimated H-index: 10
(UBC: University of British Columbia),
Alan Brennan34
Estimated H-index: 34
(UBC: University of British Columbia)
+ 1 AuthorsNick Bansback32
Estimated H-index: 32
(UBC: University of British Columbia)
The Sheffield RA health economic model has been used in several published cost-effectiveness analyses in both the UK and internationally to evaluate different treatments for patients with RA. This article presents the key methods and assumptions that underpin the model, including justifications for using an individual patient sampling methodology, and why the model has used the HAQ to track disease activity. The article also details how trial and observational data are used in the model to addre...
Cited By9
Newest
Published on May 20, 2019in PLOS ONE2.78
Yi Pan , Sam Norton24
Estimated H-index: 24
+ 6 AuthorsSuzanne M. M. Verstappen29
Estimated H-index: 29
Background United Kingdom guidelines for the use of biologic disease modifying anti-rheumatic drugs (bDMARDS) for rheumatoid arthritis (RA) require patients to have active disease (Disease Activity Score [DAS28] >5.1) and have failed ≥2 previous conventional synthetic DMARDs (csDMARD). Patients with moderate disease activity (MDA) do not meet these criteria, yet often have poor outcomes. This study aimed to identify trajectory groups of disability scores over three years in RA patients with MDA....
Published on Jan 31, 2019in F1000Research
Helen Alexander1
Estimated H-index: 1
(Guy's and St Thomas' NHS Foundation Trust),
Thomas Edward Patton1
Estimated H-index: 1
(Ebor: University of York)
+ 2 AuthorsCarsten Flohr31
Estimated H-index: 31
(Guy's and St Thomas' NHS Foundation Trust)
Patients with atopic dermatitis (AD) who do not adequately respond to topical therapy and phototherapy often need systemic immunomodulatory treatment to control their symptoms. Conventional systemic agents, such as ciclosporin, azathioprine, and methotrexate, have been used for decades, but there are concerns about their safety profile. There are now many novel systemic agents emerging through clinical trials, which may have great potential in the treatment of AD. Despite this, there are very fe...
Published on Nov 1, 2018in Quality of Life Research2.49
Thomas Edward Patton1
Estimated H-index: 1
(Ebor: University of York),
Hao Hu3
Estimated H-index: 3
(University of Newcastle)
+ 2 AuthorsShu-Chuen Li31
Estimated H-index: 31
(University of Newcastle)
Objectives In order to address the current deficiency of health utility evidence relevant for economic evaluations involving treatments for rheumatoid arthritis (RA) in the Chinese setting, this study aims to develop a mapping algorithm linking the Health Assessment Questionnaire (HAQ) and EQ-5D-5L in a Chinese population of patients with RA.
Published on Oct 5, 2018in PLOS ONE2.78
E. Alemao6
Estimated H-index: 6
,
Maiwenn Al27
Estimated H-index: 27
(EUR: Erasmus University Rotterdam)
+ 5 AuthorsMaureen Rutten-van Mölken44
Estimated H-index: 44
(EUR: Erasmus University Rotterdam)
The objective of this study was to evaluate current approaches to economic modeling in rheumatoid arthritis (RA) and propose a new conceptual model for evaluation of the cost-effectiveness of RA interventions. We followed recommendations from the International Society of Pharmacoeconomics and Outcomes Research-Society of Medical Decision Making (ISPOR-SMDM) Modeling Good Research Practices Task Force-2. The process involved scoping the decision problem by a working group and drafting a prelimina...
Published on Jan 1, 2018in PharmacoEconomics3.71
Emma McManus3
Estimated H-index: 3
(UEA: University of East Anglia),
Tracey Sach29
Estimated H-index: 29
(UEA: University of East Anglia),
N. J. Levell19
Estimated H-index: 19
(NNUH: Norfolk and Norwich University Hospital)
Objective The objective of this systematic review was to identify and assess the quality of published economic decision–analytic models within atopic eczema against best practice guidelines, with the intention of informing future decision–analytic models within this condition.
Published on Oct 1, 2017in Health Technology Assessment3.82
Mark Corbett4
Estimated H-index: 4
,
Fadi Chehadah1
Estimated H-index: 1
+ 8 AuthorsNerys Woolacott30
Estimated H-index: 30
BACKGROUND: Several biologic therapies are approved by the National Institute for Health and Care Excellence (NICE) for psoriatic arthritis (PsA) patients who have had an inadequate response to two or more synthetic disease-modifying antirheumatic drugs (DMARDs). NICE does not specifically recommend switching from one biologic to another, and only ustekinumab (UST; STELARA(®), Janssen Pharmaceuticals, Inc., Horsham, PA, USA) is recommended after anti-tumour necrosis factor failure. Secukinumab (...
Published on Aug 1, 2017in Clinical Rheumatology2.29
Thomas Edward Patton1
Estimated H-index: 1
(Ebor: University of York),
Laura Bojke20
Estimated H-index: 20
(Ebor: University of York)
+ 2 AuthorsPhilip S Helliwell P S55
Estimated H-index: 55
(University of Leeds)
The primary aim of this study is to explore the extent to which registry data may fulfill the evidence requirements of cost-effectiveness analysis (CEA) studies evaluating biologic therapies for the treatment of psoriatic arthritis (PsA), where trial data are lacking or insufficient. In addition, the paper aims to identify how future data collection in PsA registries might be better tailored to inform CEA research. A review of the literature was performed to identify existing registries containi...
Published on Aug 1, 2017in PharmacoEconomics3.71
Laura Bojke20
Estimated H-index: 20
(Ebor: University of York),
Andrea Manca30
Estimated H-index: 30
(Ebor: University of York)
+ 3 AuthorsStephen Palmer47
Estimated H-index: 47
(Ebor: University of York)
Costs and utilities are key inputs into any cost-effectiveness analysis. Their estimates are typically derived from individual patient-level data collected as part of clinical studies the follow-up duration of which is often too short to allow a robust quantification of the likely costs and benefits a technology will yield over the patient’s entire lifetime. In the absence of long-term data, some form of temporal extrapolation—to project short-term evidence over a longer time horizon—is required...
Published on Mar 1, 2017in Alimentary Pharmacology & Therapeutics7.73
Graham L. Radford-Smith41
Estimated H-index: 41
(UQ: University of Queensland),
F. Hartnell (Royal Brisbane and Women's Hospital), James D. Doecke23
Estimated H-index: 23
(CSIRO: Commonwealth Scientific and Industrial Research Organisation)