Objectives: The approval in more than 50 countries of baricitinib, an oral Janus Kinase inhibitor for the treatment of Rheumatoid Arthritis (RA), warrants a framework for corresponding economic evaluations. To develop a comprehensive economic model assessing the cost-effectiveness of baricitinib for the treatment of moderately-to-severely active RA patients in comparison to other relevant treatments, considering the natural history of the disease, real world treatment patterns, and clinical evidence from the baricitinib trials.Methods: A systematic literature review of previously developed models in RA was conducted to inform the model structure, key modeling assumptions and data inputs. Consultations with rheumatologists were undertaken to validate the modeling approach and underlying assumptions.Results: A discrete event simulation model was developed to international best practices with flexibility to assess the cost-effectiveness of baricitinib over a lifetime in a variety of markets. The model incorporates treatment sequencing to adequately reflect treatment pathways in clinical practice. Outcomes assessed include cost and quality-adjusted life years, allowing for a full incremental analysis of cost-effectiveness of competing treatments and treatment sequences.Conclusion: The economic model developed provides a robust framework for future analyses assessing the cost-effectiveness of baricitinib for the treatment of RA in specific country settings.

中文翻译：

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经济评估巴里替尼在中度至重度类风湿关节炎中的模型框架。

目标：Baricitinib是一种口服Janus Kinase抑制剂，用于治疗类风湿关节炎（RA），在50多个国家/地区获得批准，这为进行相应的经济评估提供了框架。考虑到疾病的自然病史，现实世界的治疗模式以及临床证据，建立一个综合经济模型，评估巴立替尼治疗中度至重度活动性RA患者与其他相关治疗相比的成本效益。方法：对RA中先前开发的模型进行系统的文献综述，以告知模型结构，关键建模假设和数据输入。与风湿病学专家进行了协商，以验证建模方法和基本假设。针对国际最佳实践开发了离散事件模拟模型，该模型可以灵活地评估baricitinib在各种市场中的整个生命周期内的成本效益。该模型结合了治疗顺序，以充分反映临床实践中的治疗途径。评估的结果包括费用和质量调整的生命年限，从而可以对竞争性疗法和治疗顺序的成本效益进行全面的增量分析。结论：开发的经济模型为将来评估巴利替尼治疗的成本效益提供了一个可靠的框架。在特定国家/地区治疗RA。该模型结合了治疗顺序，以充分反映临床实践中的治疗途径。评估的结果包括费用和质量调整的生命年限，从而可以对竞争性疗法和治疗顺序的成本效益进行全面的增量分析。结论：开发的经济模型为将来评估巴利替尼治疗的成本效益提供了一个可靠的框架。在特定国家/地区治疗RA。该模型结合了治疗顺序，以充分反映临床实践中的治疗途径。评估的结果包括费用和质量调整的生命年限，从而可以对竞争性疗法和治疗顺序的成本效益进行全面的增量分析。结论：开发的经济模型为将来评估巴利替尼治疗的成本效益提供了一个可靠的框架。在特定国家/地区治疗RA。