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Background <p>Etrasimod (2&#xa0;mg orally, once daily) is a novel advanced therapy (AT) for patients aged 16 years and older, with moderately-to-severely active ulcerative colitis (UC). This cost-effectiveness analysis compared etrasimod with biologics for the treatment of moderately-to-severely active UC within the Spanish healthcare system.</p> Methods <p>A mixed model was used to estimate direct health-related costs (€, 2025) and outcomes (quality-adjusted life years [QALYs]) during the patient’s lifetime (annual discount rate: 3%). The model simulated the course of UC, including induction and maintenance treatments, modeled by a decision tree and a Markov model. Model inputs were derived from scientific literature. All data were validated by a multidisciplinary panel of national experts. Etrasimod was compared against commonly used treatments in Spain in AT-naïve (vs adalimumab, golimumab, infliximab, intravenous vedolizumab [vedolizumab-IV], subcutaneous vedolizumab [vedolizumab-SC]) and AT-experienced patients (vs adalimumab, golimumab, infliximab, ustekinumab, vedolizumab-IV, vedolizumab-SC) by estimating incremental cost-effectiveness ratios.</p> Results <p>Etrasimod yielded 19.505 QALYs and €600,289 per AT-naïve patient lifetime, being associated with more QALYs and cost savings than adalimumab (+0.042; −€35,084), golimumab (+0.107; −€39,424), infliximab (+0.039; −€49,514), vedolizumab-IV (+0.170; −€16,153) and vedolizumab-SC (+0.166; −€55,850). In AT-experienced patients, etrasimod produced 18.407 QALYs and €589,423/patient lifetime. In this population, etrasimod was also associated with more QALYs and cost-savings versus adalimumab (+0.013; −€20,850), ustekinumab (+0.018; −€39,354), vedolizumab-IV (+0.166; −€572) and vedolizumab-SC (+0.171; −€26,890). Etrasimod was dominant versus all biologic therapies. Deterministic and probabilistic sensitivity analyses varying all model inputs confirmed the robustness of the results (etrasimod dominancy).</p> Conclusions <p>In AT-naïve and AT-experienced patients, etrasimod is a dominant therapy (cost savings, greater effectiveness) compared with commonly used ATs.</p>

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Cost-Effectiveness Analysis of Etrasimod Compared With Biologic Therapies for the Treatment of Patients with Moderately-to-Severely Active Ulcerative Colitis in Spain

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月16日

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  • Iago Rodríguez-Lago,
  • Fernando Muñoz Núñez,
  • Alfredo J. Lucendo,
  • Alfonso De Lossada Juste,
  • Ana Cabez,
  • Alberto de la Cuadra-Grande,
  • Itziar Oyagüez,
  • Emilio Monte-Boquet

摘要

Background

Etrasimod (2 mg orally, once daily) is a novel advanced therapy (AT) for patients aged 16 years and older, with moderately-to-severely active ulcerative colitis (UC). This cost-effectiveness analysis compared etrasimod with biologics for the treatment of moderately-to-severely active UC within the Spanish healthcare system.

Methods

A mixed model was used to estimate direct health-related costs (€, 2025) and outcomes (quality-adjusted life years [QALYs]) during the patient’s lifetime (annual discount rate: 3%). The model simulated the course of UC, including induction and maintenance treatments, modeled by a decision tree and a Markov model. Model inputs were derived from scientific literature. All data were validated by a multidisciplinary panel of national experts. Etrasimod was compared against commonly used treatments in Spain in AT-naïve (vs adalimumab, golimumab, infliximab, intravenous vedolizumab [vedolizumab-IV], subcutaneous vedolizumab [vedolizumab-SC]) and AT-experienced patients (vs adalimumab, golimumab, infliximab, ustekinumab, vedolizumab-IV, vedolizumab-SC) by estimating incremental cost-effectiveness ratios.

Results

Etrasimod yielded 19.505 QALYs and €600,289 per AT-naïve patient lifetime, being associated with more QALYs and cost savings than adalimumab (+0.042; −€35,084), golimumab (+0.107; −€39,424), infliximab (+0.039; −€49,514), vedolizumab-IV (+0.170; −€16,153) and vedolizumab-SC (+0.166; −€55,850). In AT-experienced patients, etrasimod produced 18.407 QALYs and €589,423/patient lifetime. In this population, etrasimod was also associated with more QALYs and cost-savings versus adalimumab (+0.013; −€20,850), ustekinumab (+0.018; −€39,354), vedolizumab-IV (+0.166; −€572) and vedolizumab-SC (+0.171; −€26,890). Etrasimod was dominant versus all biologic therapies. Deterministic and probabilistic sensitivity analyses varying all model inputs confirmed the robustness of the results (etrasimod dominancy).

Conclusions

In AT-naïve and AT-experienced patients, etrasimod is a dominant therapy (cost savings, greater effectiveness) compared with commonly used ATs.