OBJECTIVE: To examine the clinical and economic impact of vedolizumab compared with conventional therapy in the treatment of moderately to severely active ulcerative colitis (UC) in the United Kingdom based on results of the GEMINI I trial.
METHODS: A decision-analytic model in Microsoft Excel was used to compare vedolizumab with conventional therapy (aminosalicylates, corticosteroids, immunomodulators) for the treatment of patients with UC in the United Kingdom. We considered the following three populations: the overall intent-to-treat population from the GEMINI I trial, patients naïve to anti-tumor necrosis factor (anti-TNF) therapy, and those who had failed anti TNF therapy. Population characteristics, efficacy data, and health-state utility data were obtained from the published literature. Other inputs (eg, unit costs, probability of surgery, mortality) were obtained from published literature. Time horizon was a lifetime horizon, with costs and outcomes discounted by 3.5% per year. One-way and probabilistic sensitivity analyses were conducted to measure the impact of parameter uncertainty.
RESULTS: Vedolizumab had incremental cost-effectiveness ratios of £4,095/quality-adjusted life-year (QALY), £4,423/QALY, and £5,972/QALY for compared with conventional therapy in the intent-to-treat, anti-TNF–naïve, and anti-TNF–failure populations, respectively. Patients on vedolizumab accrued more QALYs while incurring more costs than patients on conventional therapy. The sensitivity analyses showed that the results were most sensitive to induction response and transition probabilities for each treatment.
CONCLUSIONS: The results suggest that vedolizumab results in more QALY and may be a cost effective treatment option compared with conventional therapy for both anti-TNF–naïve and anti-TNF–failure patients with moderately to severely active UC.
