P026 Cost per Response/Remission analysis of biologic therapies availables in Argentina for the treatment of Bio-exposed patients with moderate-to-severe active Ulcerative Colitis
Elgart, J.(1);Balderramo, S.(2);Calvi, G.(3);Kanevsky, D.(3);Sánchez Gonzalez, Y.(4)*;
(1)CENEXA. Center of Experimental and Applied Endocrinology, Health Economics, La Plata, Argentina;(2)Hospital Privado Universitario de Cordoba, Gastroenterology Department, Cordoba, Argentina;(3)AbbVie Argentina, Market Access, Buenos Aires, Argentina;(4)AbbVie Inc., HEOR Strategy – Ulcerative Colitis, Chicago, United States;
Background
Response and remission are among the most clinically relevant outcomes for patients treated for ulcerative colitis (UC). The aim of the study is comparing the cost of a sustained clinical response or remission (at 52 weeks’ follow-up) across biologics available in Argentina for the treatment of bio-exposed patients with moderate-to-severe UC.
Methods
Using a model developed in Excel, which combine efficacy event rates (clinical response/remission) and treatment costs, we estimated the cost per response or remission of the following UC treatments: adalimumab (ADA), tofacitinib (TOFA), upadacitinib (UPA), ozanimod, ustekinumab and vedolizumab (VEDO). Event rates were obtained from a published network meta-analysis (NMA) of Phase 3 randomized controlled trials (RCTs) in moderately-to-severely active UC (bio-naïve or bio-exposed patients) for the following efficacy outcomes: Clinical response and Clinical remission per Full Mayo (FM) score. Costs of treatments were estimated based on approved regimens and doses of each drug as well as drug prices obtained from a publicly available list of prices. The cost per event was calculated as treatment cost divided by efficacy rate. For sensitivity, costs per event were also calculated using the 95% credible intervals from the NMA efficacy results. Costs per response/remission are expressed in US-dollars (exchange rate: US$1=AR$152.25, Sept 2022).
Results
Considering the Clinical Response at 52 weeks, the lowest cost per responder therapies were: UPA (induction x maintenance: 45mg QD x 15mg QD) $58.216 [95% CrI $42.854 - $98.094]; UPA (45mg QD x 30mg QD) $79.270 [$62.146 - $121.400]; TOFA (10mg BID x 5mg BID) $109.708 [$65.205-$ 232.217]; and TOFA (10mg BID x 10mg BID) $154.218 [$99.169 -$296.204]. 
Likewise considering sustained remission the lowest costs per responder therapies were: UPA (45mg QD x 15mg QD) $64.782 [$42.658 - $136.390]; UPA (45mg QD x 30mg QD) $92.874 [$64.488 - $182.236]; VEDO (300mg x 300mg Q8W) $278.299 [$124.766 - $779.009]; and TOFA (10mg BID x 5mg BID) $305.534 [$126.845 - $904.439]. The cost per responder was consistently lower for upadacitinib compared to all biologic treatments available in Argentina across both clinical measures.
Conclusion
Among therapies for the treatment of bio-exposed patients with moderate-to-severe UC evaluated, upadacitinib have shown the lowest median cost per clinical remission and response from an Argentinian healthcare payer perspective.