Health economic evaluation of a new antibody biomarker screening test

Möbius developed an interactive health economic model for UHasselt BIOMED in order to assess the cost-effectiveness of a new medical intervention.

Introduction

Rheumatoid arthritis (RA) is a chronic autoimmune condition that primarily affects the joints, causing pain, inflammation, and potential joint damage over time. In the last two decades, a paradigm shift in RA disease management has been highly successful in driving back disease activity, resulting in reduced damage and disability for an increasing number of patients. This has been achieved by focusing on the early recognition and diagnosis of patients, the application of early intensive treatment and the availability of many types of novel therapies and their use in treatment escalation.

In the treatment of RA, various types of medication are used, often administered concurrently or sequentially for prolonged periods of time. The treatment strategy can generally be divided into first-line and second-line approaches. After initial diagnosis of RA, treatment with conventional first-line therapy (Conventional synthetic DMARD’s) is initiated. Second-line therapy (Biological DMARD’s) becomes accessible and reimbursed if two types of conventional treatment have not led to an improved outcome for the patient.

UHasselt BIOMED investigates the use of antibody biomarkers screening: a positive antibody biomarker test indicates the presence of specific antibodies predicting non-response to first-line therapy. In the case of a positive test, a patient would benefit more from earlier access to second-line therapy.

Strategic challenge

UHasselt wanted to assess the cost-effectiveness of the use of antibody biomarker screening in determining therapy response. To this end, Möbius was asked to perform a health economic analysis of the intervention and develop an interactive cost-effectiveness model.

The team at Möbius is very professional, up-to-date with the topic we had, and provided an amazing service. The team followed up with us and made sure our questions were answered and everything was clear. We totally recommend working with Mobius.

Sukayna Fadlallah Researcher at UHasselt BIOMED

Approach

In order to conduct a comprehensive health economic analysis, the approach involved mapping the ‘AS IS’ scenario (standard therapy of care) and ‘TO BE’ scenario (intervention with antibody biomarker screening) for the given medical intervention. This mapping encompasses the entire care pathway, identifying the different steps involved and evaluating their costs and health effects. In order to obtain a comprehensive overview of the treatment trajectories, both the available literature as well as expert opinions were consulted.

Based on the identified patient pathways, an interactive Markov model was developed to assess the cost-effectiveness of the intervention in comparison to the standard of care. The construction of the model includes defining relevant "health states" and determining the transitions between them. Transition probabilities are assigned to represent the likelihood of patients moving from one health state to another during the care pathway. By additionally linking the corresponding cost and health effect to each health state, it is possible to compare both care pathways in terms of cost-effectiveness.

The results were presented in terms of expected direct medical costs, quality-adjusted life-years, and the incremental cost-effectiveness ratio. This ratio indicates the incremental cost required to gain an additional quality-adjusted life-year over a five-year period, considering the perspective of healthcare payers.

The guidelines of the Belgian Healthcare Knowledge Centre (KCE) were taken into account to ensure the methodological quality, transparency, and uniformity of the health economic analysis. The following table provides an overview of the basic elements of the economic evaluation that were applied in this health economic assessment in accordance with the KCE guidelines:

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For the valuation of healthcare costs, the technical cell data from the FPS was used. To efficiently access this data, Möbius developed an interactive dashboard. Click here for more information on how to use this dashboard.

For more information on the importance and handling of real-world data in HTA’s, check our interactive dashboard.

Results

A final report was drawn up - according to the reporting standards of the KCE - which focused on giving Uhasselt BIOMED a clear understanding of the methodology and initial results. This report includes a comprehensive explanation of the objectives, elements of economic evaluation, results, discussion, and references.

Additionally, a hands-on interactive model was delivered. Given the early stage in the research and limited clinical data, the interactive model can be used by the team at UHasselt BIOMED to adapt parameter values and test multiple scenarios in terms of cost-effectiveness.

Written by

Gert-Jan Dossche

Thomas Haspeslagh

Sarah Misplon

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