Identifying characteristics for a cost-effective psoriatic arthritis biomarker test: a development-focused health technology assessment
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Le résumé fourni par la source
OBJECTIVES: This study aimed to evaluate the required test characteristics that a psoriatic arthritis (PsA) biomarker test would need to achieve to be considered cost-effective. METHODS: We adapted an existing Markov model to compare a hypothetical biomarker with current practice. The model followed a patient cohort aged 45 years with moderate psoriasis (PsO) in which PsA was prevalent but unrecognized over a 40-year time horizon. Patients were assumed to be routinely seen at a dermatology clinic. In the current practice arm, patients with PsA were clinically detected. In the biomarker arm, a hypothetical test was assumed to be administered at baseline. Patients who screened positive would accept a combination of conventional disease-modifying antirheumatic drugs and targeted treatment to slow disease progression. Progression was modeled as linear changes in Health Assessment Questionnaire (HAQ) scores. We varied the sensitivity, specificity, and biomarker price based on current development progress. Scenario analyses considered alternative patient cohorts with mild and severe PsO separately. RESULTS: The base case showed that a biomarker test with 70 percent sensitivity, 80 percent specificity, and a price of US$500 would be cost-effective (incremental cost-effectiveness ratio US$47,566 per quality-adjusted life-year [QALY]). Three-way analyses showed that a test with 80 percent specificity could be cost-effective at a US$50,000 per QALY threshold with a sensitivity as low as 66 percent at US$500. Only a near-perfect test would be cost-effective at a US$1,000 price point. Results were sensitive to HAQ progression under treatment, therapy costs, and the patient population. CONCLUSION: This study supports the continued product development of candidate PsA biomarkers.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Identifying characteristics for a cost-effective psoriatic arthritis biomarker test: a development-focused health technology assessment
- Date Crossref
- 01/01/2025
- Éditeur
- Cambridge University Press (CUP)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Providence Health Care pays non établi dans la noticeÉtablissement de santé
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St. Paul's Hospital Providence Research pays non établi dans la noticeÉtablissement de santé
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University of Toronto Department of Laboratory Medicine and Pathobiology pays non établi dans la noticeUniversité ou école supérieure
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Krembil Foundation pays non établi dans la noticeOrganisation à but non lucratif
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Krembil Research Institute pays non établi dans la noticeStructure de recherche
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University Health Network Laboratory Medicine Program pays non établi dans la noticeÉtablissement de santé
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University of Calgary Community Health Sciences pays non établi dans la noticeUniversité ou école supérieure
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University of British Columbia pays non établi dans la noticeUniversité ou école supérieure
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School of Population and Public Health pays non établi dans la noticeUniversité ou école supérieure
Providence Health Care, Providence Research — St. Paul's Hospital et Department of Laboratory Medicine and Pathobiology — University of Toronto, avec 6 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.