ABSTRACT

Background: TNF inhibitors are costly drugs supplied generally on health systems or private insurances. Performance analysis is essential to verify the results achieved by health technologies in these systems. The objective of the study was to compare the two most used biological drugs for the treatment of psoriatic arthritis (PsA) in Brazil.

Methods: A cost-utility analysis was built using a Markov model, with a five-year time horizon, a discount rate of 5%, and from the perspective of the Unified Health System. Deterministic and probabilistic sensitivity analyses were performed.

Results: Etanercept was the most cost-effective drug. Adalimumab became the most cost-effective drug in one of the four analysis scenarios with a willingness to pay from one gross domestic product per capita. The deterministic sensitivity analysis identified that the cost parameters had the greatest impact on the most effective drug. The probabilistic sensitivity analysis indicated that etanercept is the drug most likely to be cost-effective.

Conclusion: The difference between the drugs in terms of utility was minimal and the costs were the main factor that impacted the cost-utility ratio, which points to the benefits of price renegotiation for the efficient allocation of resources in the health system.

摘要

背景：TNF 抑制剂是一种昂贵的药物，通常由卫生系统或私人保险提供。性能分析对于验证卫生技术在这些系统中取得的成果至关重要。该研究的目的是比较在巴西治疗银屑病关节炎 (PsA) 的两种最常用的生物药物。

方法：使用马尔科夫模型进行成本效用分析，时间跨度为 5 年，贴现率为 5%，从统一卫生系统的角度进行。进行了确定性和概率敏感性分析。

结果：依那西普是最具成本效益的药物。阿达木单抗成为四种分析情景之一中最具成本效益的药物，愿意从人均国内生产总值中支付。确定性敏感性分析确定成本参数对最有效的药物影响最大。概率敏感性分析表明，依那西普是最有可能具有成本效益的药物。

结论：药物在效用方面的差异很小，成本是影响成本效用比的主要因素，这表明价格重新谈判有利于卫生系统资源的有效配置。