Cost-Effectiveness of Vedolizumab for the Treatment of Adult Patients with Moderately-to-Severely Active Ulcerative Colitis in Russia

BACKGROUND: Vedolizumab is one of the biologic drugs recommended by current clinical guidelines for the treatment of moderately-to-severely active ulcerative colitis (UC) in Russia. OBJECTIVES: To estimate the cost-effectiveness of vedolizumab compared with alternative strategies in the management of patients with UC who have had an inadequate response with, lost response to, or were intolerant to conventional therapy without anti-TNF-a inhibitors. METHODS: The global UK Markov model was populated with the Russian-specific input data. The target model population included patients with moderately-to-severely active UC who had demonstrated an inadequate response, lost response or had been intolerant to a conventional therapy. The model compared vedolizumab with infliximab (originator and biosimilar) as well as conventional therapy from the perspective of the Russian healthcare system for the 5-year time horizon. A 5% discount factor was used for costs and outcomes. The incremental cost-effectiveness ratio (ICER) per quality-adjusted life year (QALY) was calculated. RESULTS: Vedolizumab required additional costs per additional QALY gained of 3.19 million rubles (49,669 euro) when compared to conventional therapy in UC patients. There was a small reduction in medical costs after correcting for disease progression and adverse effects. Concurrently, patients who received vedolizumab had longer sustained clinical remission, higher general survival rate, and lower need for surgery. When compared to originator infliximab, who have not been treated previously with anti-TNF-a inhibitors, vedolizumab was associated with lower costs and higher effectiveness. When compared to equal-share use of original and biosimilar infliximab, vedolizumab incurred an additional cost of 577,869 rubles (8,990 euro) per QALY gained. CONCLUSIONS: Vedolizumab is a dominant alternative in anti-TNF-a-naive patients with UC, compared with originator infliximab. It is also a cost-effective option compared to equal-share use of originator and biosimilar infliximab.