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首页> 外文期刊>British journal of ophthalmology >Adalimumab for non-infectious uveitis: is it cost-effective?
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Adalimumab for non-infectious uveitis: is it cost-effective?

机译：非传染性葡萄膜炎的阿达木单价：它是否具有成本效益？

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Uveitis is inflammation inside the eye. Our objective was to assess the cost-effectiveness of adalimumab compared with current practice (immunosuppressants and systemic corticosteroids) in patients with non-infectious intermediate, posterior or panuveitis and to identify areas for future research.A Markov model was built to estimate costs and benefits of the interventions. Systematic reviews were performed to identify the available relevant clinical and cost-effectiveness evidence. Data collected in two key randomised controlled trials (VISUAL I and VISUAL II) were used to estimate the interventions’ effectiveness compared with the trials’ comparator arms (placebo plus limited current practice (LCP)). The analysis was performed from the National Health Service and Personal Social Services perspective. Costs were calculated based on standard UK sources.The estimated incremental cost-effectiveness ratios (ICERs) of adalimumab versus LCP for the base case are ￡92?600 and ￡318?075 per quality-adjusted life year (QALY) gained for active and inactive uveitis, respectively. In sensitivity analyses, the ICER varied from ￡15?579 to ￡120?653 and ￡35?642 to ￡800?775 per QALY for active and inactive uveitis.The estimated ICERs of adalimumab versus LCP are above generally accepted thresholds for cost-effectiveness in the UK. Adalimumab may be more cost-effective in patients with active uveitis at greater risk of blindness. However, there is an unmet need for additional primary data to provide more reliable estimates in several important areas, including effectiveness of adalimumab versus current practice (instead of LCP), incidence of long-term blindness, adalimumab effectiveness in avoiding blindness, and rates and time to remission while on adalimumab.
机译：葡萄膜炎是眼内的炎症。我们的目的是评估阿达木单抗的成本效益与当前的非传染性中间体，后部或恐慌炎的患者的实践（免疫抑制剂和全身性皮质类固醇）相比，以及识别未来研究的领域。马尔可夫模型是为了估算成本和福利而建造的干预措施。进行系统评价，以确定可用的相关临床和成本效益证据。在两个关键随机控制试验（Visual I和Visual II）中收集的数据用于与试验的比较器臂（安慰剂加上有限实践（LCP））进行干预措施。分析来自国家卫生服务和个人社会服务视角。基于标准英国来源计算成本.Adalimalab的估计增量成本效益比率（股票案件为LCP是92英镑？600和318英镑？075每个质量调整的生命年份（QALY）获得活跃和不活跃的葡萄膜炎。在敏感性分析中，转换器从15英镑变化，从£15？579到120英镑？653和35英镑？642至800英镑？每QALY为642至£800？775，用于活性和无活性葡萄炎。估计的Adalimalab与LCP的估计值高于通常接受的阈值在英国的有效性。在患有更大的失明风险的患者中，Adalimumab可能更具成本效益。然而，有一个未满足的需要进行额外的主要数据，以在几个重要领域提供更可靠的估计，包括Adalimalab与当前实践的有效性（而不是LCP），长期失明的发生率，避免失明，以及避免失明的效果在Adalimumab上缓解的时间。

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