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New ICER report reveals most cost-effective rheumatoid arthritis therapies

Published on 27/11/19 at 01:48pm

The Institute for Clinical and Economic Review (ICER) has unveiled a new report comparing the clinical efficacy and cost-effectiveness of three JAK inhibitors for treating rheumatoid arthritis (RA): AbbVie’s Rinvoq (upadacitinib), Pfizer’s Xeljanz (tofacitinib), and Eli Lilly’s Olumiant (baricitinib).

Head-to-head data revealed that Rinvoq demonstrated “statistically-significant but modestly higher rates of disease remission and improvement in other important outcomes” compared to AbbVie’s best-selling drug Humira; the report asserted that it could be assumed with “moderate certainty” that the drug offering a “small to substantial net health benefit” in this comparison.

The report also noted with “high certainty” that, compared to Humira, Xeljanz offered a “comparable net health benefit”. Olumiant and Humira were not compared.

Additionally, both Rinvoq and Xeljanz were found with “high certainty” to offer “substantial net health benefit” compared to conventional Disease Modifying Antirheumatic Drugs (cDMARDs).

From a cost-effectiveness standpoint, the report argued that a combination of Rinvoq with a cDMARD provided “marginally higher quality of life” at a similar cost compared to Humira plus a cDMARD, placing ICER’s value-based price benchmark for the former therapy at between $44,000 and $45,000.

“Rheumatoid arthritis is a progressively disabling condition, and patients are fortunate to have multiple therapy options that are this effective at slowing disease progression,” said Dr Pamela Bradt, ICER’s Chief Scientific Officer. “Our evidence review suggests that upadacitinib is modestly more effective than adalimumab, whereas the evidence cannot demonstrate added effectiveness for tofacitinib, and we found no evidence with which to compare baricitinib to adalimumab. Policymakers will need to consider how to judge the value of a new treatment when its direct competitors are not fairly priced to begin with.”

Matt Fellows

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