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Number Needed to Treat and Cost Per Responder of Janus Kinase Inhibitors Approved for the Treatment of Moderate-to-Severe Rheumatoid Arthritis in Japan.

T. Atsumi,Eri Asakura,Michio Doi,R. Sawant,I. Kawaguchi,N. Sasaki,D. Liew

Published 2022 in Modern Rheumatology

ABSTRACT

OBJECTIVE This study evaluated the effectiveness and cost-effectiveness of baricitinib, tofacitinib and upadacitinib regimens, compared to conventional synthetic disease-modifying antirheumatic drug (csDMARD) alone, among Japanese patients with moderate-to-severe rheumatoid arthritis (RA) inadequately responsive to csDMARD, measured in terms of number needed to treat (NNT) and cost per responder (CPR). METHODS Efficacy data were derived from two recent network meta-analyses among global and Japanese population. The cost perspective was that of the Japanese Health Service. Both NNT and CPR were based on disease activity score for 28 joints with C-reactive protein (DAS28-CRP) remission and American College of Rheumatology (ACR)20/50/70 at 12 and 24 weeks. RESULTS Over 12 weeks, the median NNT and the median CPR to achieve DAS28-CRP remission were 4.3 and JPY 1,799,696 [USD 16,361], respectively, for upadacitinib 15mg + csDMARD. The equivalent results were 6.0 and JPY 2,691,684 [USD 24,470] for baricitinib 4mg + csDMARD and 5.6 and JPY 2,507,152 [USD 22,792] for tofacitinib 5mg + csDMARD. Similar rankings were observed at 24 weeks and for other outcomes. CONCLUSIONS Upadacitinib 15mg was associated with the lowest NNT and CPR among the three JAK inhibitors used in treatment regimens for Japanese patients with moderate-to-severe RA inadequately responsive to csDMARD.

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