Modeled health economic impact of a hypothetical certolizumab pegol risk-sharing scheme for patients with moderate-to-severe rheumatoid arthritis in Finland

Soini E, Asseburg C, Taiha M, Puolakka K, Purcaru O, Luosujärvi R

Risk sharing can improve health outcomes and save money in rheumatoid arthritis care in Finland

In Finland, risk sharing schemes (RSS) are considered as part of new reimbursement applications starting 1 January 2017.  Under an RSS, uptake of new therapies may be increased and budget concerns may be overcome.

We evaluated whether the use of RSS could improve uptake of certolizumab pegol (CZP) in the treatment of rheumatoid arthritis (RA).  Long-term response to CZP can be predicted from a 12-week efficacy assessment, which provides a rationale for a RSS.

An open-cohort health-economic model was designed and implemented to compare CZP with RSS to the current mix of biologic treatments in use for RA.  Efficacy of biologic therapies was estimated in a network meta-analysis.  A five-year time horizon was used and both societal and payer perspective were evaluated.

In a cost-effectiveness analysis, CZP was found to reduce overall costs by €7866 per patient and provide better health outcomes (0.03 QALYs gained).  In a budget impact analysis, the CZP RSS was associated with reduction of total costs by 5.6%, with about half of these reductions due to savings in productivity losses.

In conclusion, CZP appears to be cost effective with or without an RSS, and the surplus provided by the CZP RSS would be equivalent to the cost of treating approximately 6% of Finnish RA patients.


Accepted in Advances in Therapy, 2017.