Abstract:
OBJECTIVES: Juvenile idiopathic arthritis is the most common chronic rheumatic disease in childhood. In this light, the aim of the present study was to perform a cost-comparison analysis of tofacitinib compared to currently marketed available treatment for active polyarticular juvenile idiopathic arthritis (JIA) in patients 2 years of age and older who have responded inadequately to previous therapy with disease-modifying antirheumatic drug in Greece.
METHODS: Based on local clinical practice, adalimumab is the most widely used biologic therapy for JIA in Greece and was therefore chosen as comparator. The indirect treatment comparison showed no statistically significant differences between tofacitinib and adalimumab in terms of risk of disease flare and ACR Pedi response. As such, a cost-comparison was performed to capture the economic consequences for treatment of JIA with different agents over a 25 year- horizon. A Markov state-transition decision model with 3-month cycle was used from public payer perspective. Direct medical costs (prices €, 2022) included drug acquisition& administration costs, complications events and disease management costs. Model outcome was evaluated in terms of per patient total therapy cost for each comparator. All future outcomes were discounted at 3.5% per annum. Sensitivity analyses explored the impact of changes in input data.
RESULTS: The analysis indicated that over a lifetime horizon, the total cost per patient for tofacitinib and adalimumab were estimated to be €88,177 and €93,905 respectively. Tofacitinib was estimated to a be cost-saving treatment option over adalimumab (-€5,728). It is of great importance the fact that the added economic value of tofacitinib versus adalimumab was corroborated after numerous sensitivity analyses.
CONCLUSIONS: Tofacitinib is likely to provide similar or greater health benefits at lower cost compared to adalimumab for the treatment of patients aged 2 years and older with active JIA in Greece.