Comparative Cost-Effectiveness of Advanced Treatment Sequences for Moderately to Severely Active Ulcerative Colitis in Japan

What To Know

This modeling study compared cost-effectiveness of 79 advanced treatment sequences for moderately to severely active ulcerative colitis in Japan.

Using a hybrid decision-tree + Markov model adapted to Japanese practice, the authors report that first-line etrasimod followed by second-line upadacitinib was the most cost-effective sequence under the study's assumptions and the Japanese willingness-to-pay threshold.

The analysis included multiple available advanced therapies (oral S1P modulators like etrasimod and ozanimod; JAK inhibitors including upadacitinib and tofacitinib; biologics such as anti-TNF agents adalimumab, golimumab, infliximab; vedolizumab; and ustekinumab) and modeled lifetime clinical and economic outcomes with treatment switching rules.

Results are model-based and intended to inform sequencing considerations alongside clinical judgement, safety, and patient preferences.

Key limitations noted by the authors include reliance on network meta-analysis inputs, model assumptions about treatment effects and sequencing, and adaptation to the Japanese healthcare setting; real-world effectiveness, safety, and individual patient factors can change optimal choices.