Modelling Adverse Events in Patients Receiving Chronic Oral Corticosteroids in the UK

Area of Science:

• Health Economics
• Pharmacoeconomics
• Clinical Modeling

Background:

• Oral corticosteroids (OCS) are effective anti-inflammatory drugs but associated with significant adverse events (AEs) and healthcare costs.
• Biologics offer OCS-sparing alternatives, yet current models may underestimate their economic value by not fully capturing OCS-reduction benefits.
• A novel modeling approach is presented to accurately assess the health economic advantages of OCS-sparing regimens.

Purpose of the Study:

• To develop and present a disease-agnostic model to quantify the health economic benefits of OCS-sparing treatments.
• To capture the long-term cost savings and quality-adjusted life-years (QALYs) associated with reduced OCS use.
• To inform decision-making for new OCS-sparing therapeutics.

Main Methods:

• A UK health technology assessment (HTA) perspective was adopted for a disease-agnostic model with a lifetime horizon and 4-week cycles.
• Key OCS-related adverse events (type 2 diabetes, cardiovascular disease, osteoporosis) were incorporated.
• Quality-adjusted life-years (QALYs), life-years, and costs were calculated for OCS-only versus 50% OCS-sparing treatment arms at various daily doses (5, 10, 15 mg).

Main Results:

• A 50% OCS dose-sparing regimen resulted in significant lifetime incremental cost savings per patient, ranging from £1107 to £19,501 depending on the OCS dose.
• Patients experienced gains in QALYs, ranging from 0.033 to 0.356, also dose-dependent.
• The health economic benefits of OCS sparing were substantial and long-term, stabilizing after 35-40 years.

Conclusions:

• The developed modeling approach effectively captures the long-term health economic benefits of OCS sparing, which are often missed by conventional methods.
• These findings provide valuable insights for comparing the cost-effectiveness of emerging OCS-sparing therapeutics.
• The study highlights the significant economic advantages of strategies aimed at reducing oral corticosteroid reliance.