Cost-effectiveness of adalimumab for early-stage Dupuytren's disease : an economic evaluation based on a randomized controlled trial and individual-patient simulation model.
dc.contributor.author | Dakin, H | |
dc.contributor.author | Rombach, I | |
dc.contributor.author | Dritsaki, M | |
dc.contributor.author | Gray, A | |
dc.contributor.author | Ball, C | |
dc.contributor.author | Lamb, SE | |
dc.contributor.author | Nanchahal, J | |
dc.date.accessioned | 2023-03-01T09:45:28Z | |
dc.date.issued | 2022-11-15 | |
dc.date.updated | 2023-02-28T16:31:12Z | |
dc.description.abstract | AIMS: To estimate the potential cost-effectiveness of adalimumab compared with standard care alone for the treatment of early-stage Dupuytren's disease (DD) and the value of further research from an NHS perspective. METHODS: We used data from the Repurposing anti-TNF for Dupuytren's disease (RIDD) randomized controlled trial of intranodular adalimumab injections in patients with early-stage progressive DD. RIDD found that intranodular adalimumab injections reduced nodule hardness and size in patients with early-stage DD, indicating the potential to control disease progression. A within-trial cost-utility analysis compared four adalimumab injections with no further treatment against standard care alone, taking a 12-month time horizon and using prospective data on EuroQol five-dimension five-level questionnaire (EQ-5D-5L) and resource use from the RIDD trial. We also developed a patient-level simulation model similar to a Markov model to extrapolate trial outcomes over a lifetime using data from the RIDD trial and a literature review. This also evaluated repeated courses of adalimumab each time the nodule reactivated (every three years) in patients who initially responded. RESULTS: The within-trial economic evaluation found that adalimumab plus standard care cost £503,410 per quality-adjusted life year (QALY) gained versus standard care alone over a 12-month time horizon. The model-based extrapolation suggested that, over a lifetime, repeated courses of adalimumab could cost £14,593 (95% confidence interval £7,534 to £42,698) per QALY gained versus standard care alone. If the NHS was willing to pay £20,000/QALY gained, there is a 77% probability that adalimumab with retreatment is the best value for money. CONCLUSION: Repeated courses of adalimumab are likely to be a cost-effective treatment for progressive early-stage DD. The value of perfect parameter information that would eliminate all uncertainty around the parameters estimated in RIDD and the duration of quiescence was estimated to be £105 per patient or £272 million for all 2,584,411 prevalent cases in the UK. Cite this article: Bone Jt Open 2022;3(11):898-906. | en_GB |
dc.description.sponsorship | Wellcome Trust | en_GB |
dc.description.sponsorship | Department of Health UK | en_GB |
dc.description.sponsorship | 180 Therapeutics LP | en_GB |
dc.description.sponsorship | National Institute for Health and Care Research | en_GB |
dc.format.extent | 898-906 | |
dc.format.medium | ||
dc.identifier.citation | Vol. 3, No. 11, pp. 898-906 | en_GB |
dc.identifier.doi | https://doi.org/10.1302/2633-1462.311.BJO-2022-0103.R2 | |
dc.identifier.grantnumber | HICF-R8-433 | en_GB |
dc.identifier.grantnumber | WT 102538/Z/14/Z | en_GB |
dc.identifier.uri | http://hdl.handle.net/10871/132582 | |
dc.identifier | ORCID: 0000-0003-4349-7195 (Lamb, Sarah E) | |
dc.identifier | ScopusID: 7101956142 (Lamb, Sarah E) | |
dc.language.iso | en | en_GB |
dc.publisher | British Editorial Society of Bone & Joint Surgery | en_GB |
dc.relation.url | https://www.ncbi.nlm.nih.gov/pubmed/36378072 | en_GB |
dc.rights | © 2022 Author(s) et al. Open Access This article is distributed under the terms of the Creative Commons Attributions (CC BY 4.0) licence (https://creativecommons.org/ licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original author and source are credited | en_GB |
dc.subject | Adalimumab | en_GB |
dc.subject | Anti-tumour necrosis factor | en_GB |
dc.subject | Cost-effectiveness analysis | en_GB |
dc.subject | Dupuytren’s disease | en_GB |
dc.subject | EQ-5D-5L | en_GB |
dc.subject | Economic evaluation | en_GB |
dc.subject | Palmar fibromatosis | en_GB |
dc.subject | Randomized controlled trial | en_GB |
dc.subject | Simulation model | en_GB |
dc.subject | flexion deformities | en_GB |
dc.subject | radiotherapy | en_GB |
dc.subject | steroid injections | en_GB |
dc.subject | linear regression models | en_GB |
dc.subject | percutaneous needle fasciotomies | en_GB |
dc.subject | sensitivity analysis | en_GB |
dc.title | Cost-effectiveness of adalimumab for early-stage Dupuytren's disease : an economic evaluation based on a randomized controlled trial and individual-patient simulation model. | en_GB |
dc.type | Article | en_GB |
dc.date.available | 2023-03-01T09:45:28Z | |
dc.identifier.issn | 2633-1462 | |
exeter.place-of-publication | England | |
dc.description | This is the final version. Available from British Editorial Society of Bone & Joint Surgery via the DOI in this record. | en_GB |
dc.description | Data sharing: Aggregate data will be shared at the end of the trial with external researchers who provide a methodologically sound proposal to the trial team (and will be required to sign a data sharing access agreement with the sponsor) and in accordance with the guidelines of the sponsor and funders. Model code may also be available in due course, on request. Study documents including participant consent form can also be made available. Requests for data or study documents should be directed to the corresponding author and will be considered by the chief investigator in conjunction with other members of the trial management group and the trials unit. | en_GB |
dc.identifier.journal | Bone & Joint Open | en_GB |
dc.relation.ispartof | Bone Jt Open, 3(11) | |
dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | en_GB |
dc.rights.license | CC BY | |
rioxxterms.version | VoR | en_GB |
rioxxterms.licenseref.startdate | 2022-11-15 | |
rioxxterms.type | Journal Article/Review | en_GB |
refterms.dateFCD | 2023-03-01T09:24:20Z | |
refterms.versionFCD | VoR | |
refterms.dateFOA | 2023-03-01T09:45:32Z | |
refterms.panel | A | en_GB |
refterms.dateFirstOnline | 2022-11-15 |
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