The Institute for Clinical and Economic Review (ICER) recently released a Final Evidence Report and Report-at-a-Glance evaluating comparative clinical effectiveness and value of the following targeted immune modulators (TIMs) for moderate-to-severe ulcerative colitis:
- Adalimumab (Humira®, AbbVie)
- Golimumab (Simponi®, Janssen)
- Infliximab (Remicade®, Janssen)
- Infliximab-abda (Renflexis®, Merck)
- Infliximab-dyyb (Inflectra®, Pfizer)
- Tofacitinib (Xeljanz®, Pfizer)
- Ustekinumab (Stelara®, Janssen)
- Vedolizumab (Entyvio®, Takeda)
ICER’s report on these therapies was reviewed at the September 2020 public meeting of the California Technology Assessment Forum (CTAF), one of ICER’s three independent evidence appraisal committees.
“Ulcerative colitis can create a lot of suffering for patients and their families and caregivers,” said Pamela Bradt, MD, MPH, ICER’s Chief Scientific Officer. “Fortunately, for patients not receiving adequate response to conventional immune modulator treatment, the evidence clearly demonstrates that targeted immune modulators often produce durable periods of clinical remission of ulcerative colitis symptoms, allowing patients to resume normal activities. However, there is very little head-to-head data comparing treatment options in this increasingly crowded, and expensive, therapy class. Prices are generally too high, even for the significant clinical benefits obtained, but the advent of biosimilars for infliximab has led to dramatic price decreases for this one agent and its biosimilars, displaying the potential cost savings that biosimilars may be able to deliver more broadly in the US. In the meantime, insurers use prior authorization, step therapy, and switching policies to try to manage the inappropriate pricing in this area, but they need to take specific actions to ensure that these policies do not prevent patients from being able to get appropriate care at a price they can afford.” Find out more here.