Cost Per Remission of Vedolizumab Versus Risankizumab for the Treatment of Moderately to Severely Active Crohn's Disease in Italy.

INTRODUCTION: Crohn's disease (CD) involves chronic gastrointestinal inflammation and requires lifelong treatment, creating an economic burden for patients and healthcare systems. Approved treatment options for CD in Italy include vedolizumab (VDZ) and risankizumab (RZB). In this analysis, a cost-per-responder model was used to evaluate the comparative value of VDZ and RZB in inducing disease remission after 1 year of treatment. METHODS: A cost-per-responder model assessed the cost per patient to achieve clinical remission after 1 year of treatment. Efficacy inputs were obtained from a previously reported matching-adjusted indirect comparison of VDZ versus RZB. Costs included drug acquisition and administration in Italy. Sensitivity analyses assessed the robustness of the results to variations in efficacy rates, efficacy outcomes, and acquisition costs. RESULTS: Cost-per-responder analysis showed that the cost per remission for patients with CD was lower for VDZ than for RZB over 1 year (€114,098 vs. €285,939; - 60.1%). A sensitivity analysis varying clinical remission rates by ± 25% showed that VDZ maintained a lower cost per remission, even when comparing simultaneous decreased VDZ and increased RZB remission rates (€152,130 vs. €228,751). Similarly, the cost per clinical response was also lower for VDZ after 1 year of treatment (€182,987 vs. €245,696), despite RZB exhibiting a numerically higher clinical response rate. Price sensitivity analysis showed that even when the acquisition costs of both RZB and VDZ were substantially discounted, VDZ consistently provided a lower cost per remission. CONCLUSIONS: In Italy, VDZ may represent a more efficient use of healthcare resources than RZB to achieve clinical remission in patients with CD. Graphical abstract available for this article https://doi.org/10.6084/m9.figshare.32456697 .