IVI Updates RA Value Assessment Model to Include Biosimilars, Sarilumab, JAK Inhibitors

The Innovation and Value Initiative (IVI) has updated its existing prototype economic model examining value among rheumatoid arthritis (RA) therapies to include biosimilars, triple therapy, Janus kinase (JAK) inhibitors, sarilumab, as well as updated treatment effect estimates based on additional randomized controlled trial (RCT) evidence, and updated cost estimates.

The update follows a research brief released last month that questioned whether "conventional head-to-head cost-effectiveness analyses may not align with decision making in chronic disease," citing an analysis of JAK inhibitors for the treatment of rheumatoid arthritis (RA).

The issue of who gets to decide "value" in an era of ever-increasing drug costs has become a point of debate in recent years.

The IVI model, IVI-RA, is intended to help payers and other stakeholders identify high-value therapies by simulating the lifetime costs and benefits of different strategies for treating patients with moderate-to-severe RA. IVI said its latest research highlights the type of additional questions important for patients, providers, and payers that make value assessments; it also incorporates real-world data.

The model is designed to examine a variety of factors with the inclusion of real-world patient data, including:

• The role of additional adverse events

• The time to treatment discontinuation
• Patient preferences
• Treatment effects after treatment failure

IVI will continue to update the model in 2020 to include the duration of maintenance treatment and the impact of prior treatment.

“Value assessments must be relevant to real-world decision makers and can be vastly improved by an ability to showcase how real patients experience disease,” says Jennifer Bright, IVI’s executive director, in a statement. “We recognize that our open-source model is just a start, which is why we are calling for partners to work with us, sharing real-world data on outcomes so we can answer even more questions. Our aim is to perfect this model to answer questions truly important to patients, providers, and payers.”

IVI-RA was the first disease-specific economic model developed within IVI’s Open-Source Value Project (OSVP), which serves as a laboratory for developing next-generation economic models in an open-source environment. The model was initially released in November 2017.