Evidence map›Paper›PMID 33644677›Full record

ArticleJournal of the Canadian Association of Gastroenterology2021

A Cost-Utility Analysis of Switching from Reference to Biosimilar Infliximab Compared to Maintaining Reference Infliximab in Adult Patients with Crohn's Disease.

Avery Hughes, John K Marshall, Myla E Moretti, Wendy J Ungar

Erratum issuedOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the Canadian Association of Gastroenterology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 8 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 3 pooled it
0.1field-weighted citation impact, top 51% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 3 syntheses or guidelines pooled it, 10 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Review
  5. A comparison of the Child Health Utility 9D and the Health Utilities Index for estimating health utilities in pediatric inflammatory bowel disease.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2023
    Article
  6. Article
  7. Article
  8. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors at 4 institutions in 1 country.

Avery HughesInstitute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
John K MarshallDepartment of Medicine and Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Ontario, Canada.
Myla E MorettiInstitute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
Wendy J UngarInstitute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
Hospital for Sick Children · CAInstitute for Clinical Evaluative Sciences · CAPopulation Health Research Institute · CASickKids Foundation · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimsLower-cost biosimilar infliximab may address affordability concerns in the treatment of adults with Crohn's disease (CD), however, evidence regarding the cost-effectiveness of switching from reference to biosimilar is warranted. The aim of this research was to assess the incremental cost of switching from treatment with reference infliximab to biosimilar compared with maintaining reference infliximab in adults with CD per quality-adjusted life year (QALY) gained.

methodsA probabilistic cohort Markov model with 8-week cycle lengths was constructed to estimate the incremental costs and effects of switching over a 5-year time horizon from a public payer perspective. Base-case clinical inputs were obtained from NOR-SWITCH subgroup analyses and other published trials. Costs were obtained from Canadian sources. A total of 10,000 simulations were run. Sensitivity analysis was used to test the robustness of the results to variations in uncertain parameters.

resultsSwitching to biosimilar infliximab was less costly but also less effective with incremental savings of $46,194 (95% confidence interval [CI]: $42,420, $50,455) and a loss in QALYs of -0.13 (95% CI: -0.16, -0.07). Eighty-three per cent of the simulations demonstrated incremental cost savings and an incremental loss of effectiveness. The model was sensitive to differences in rates of disease worsening between reference and biosimilar infliximab.

conclusionsWhile biosimilar infliximab is associated with incremental savings for patients on maintenance therapy who are switched from reference infliximab, funding decision makers must decide whether a small loss of effectiveness is justified. Further evidence will help to inform reimbursement policy.

Indexed as

Cost-utility analysisCrohn’s diseaseInfliximab

Identifiers

PMID33644677
PMCPMC7898373
OpenAlexW3006421743

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.