A Cost-Utility Analysis of Biosimilar Infliximab Compared to Reference Infliximab in Adult Switch Patients with Crohn’s Disease: A Canadian Analysis

Abstract

BACKGROUND: Lower-cost biosimilar infliximab may address affordability concerns in the treatment of adults with Crohn’s Disease (CD), however evidence regarding the costeffectiveness of switching from reference infliximab to biosimilar is warranted. PURPOSE: Assess the incremental cost of switching from treatment with reference infliximab to biosimilar compared with those who have been maintained on reference for adults with CD per quality adjusted life year (QALY) gained. METHODS: A probabilistic Markov model was constructed to estimate the incremental costs and effects over five-years. Clinical inputs were obtained from NOR-SWITCH. Costs were obtained from Canadian sources. RESULTS: Switching to biosimilar infliximab was associated with incremental costs 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). CONCLUSIONS: Switching to biosimilar infliximab is associated with incremental cost savings for adult patients with CD, however, decision makers must account for an incremental loss in effect.