Value-for-money for Innovative Medicine

Fact Sheet

Current and Forecasted Burden (Crohn's Disease)

Current and Forecasted Burden (Ulcerative Colitis)

CD Value-for-money for Innovative Medicine

UC Value-for-money for Innovative Medicine

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Crohn's Disease (CD)

Definition of innovative medicine

The candidate list of innovative medicines in the Hong Kong setting was generated from horizon scanning conducted up to 31 December 2024. Only those medicines with Phase III trial evidence were considered eligible for inclusion and were subsequently included in this analysis.

Figure: Cost-effectiveness plane and frontier of moderate-to-severe Crohn's disease strategies.

The cost-effectiveness frontier included TNF as first-line therapy, JAKi as second-line therapy, and IL-23 as second-line therapy. This indicates that these strategies were non-dominated options in the incremental cost-effectiveness analysis. Compared with TNF as first-line therapy, JAKi as second-line therapy had an ICER of HK$2,078,100 per QALY and IL-23 as second-line therapy had an ICER of HK$4,255,930 per QALY. These exceeded the WTP threshold of three times GDP per capita in Hong Kong (HK$1,265,970 per QALY).

Note:

Each point represents a treatment strategy for moderate-to-severe CD compared with TNF inhibitor therapy used as first-line treatment.
The solid line represents the efficiency frontier formed by non-dominated strategies, indicating the set of potentially cost-effective options across different WTP thresholds.

The two dashed reference lines indicate the WTP thresholds corresponding to 1× and 3× GDP per capita in Hong Kong in 2024 (HK$421,990 and HK$1,265,970 per QALY, respectively).

Abbreviations: TNF, tumor necrosis factor-alpha antagonist; IL-23, interleukin-23 inhibitor; JAKi, Janus kinase inhibitor; GDP, gross domestic product; QALY, quality-adjusted life year; WTP, willingness-to-pay.

Figure: Cost-effectiveness acceptability curves for moderate-to-severe Crohn’s disease strategies.

The two dashed reference lines indicate the WTP thresholds corresponding to 1× and 3× GDP per capita in Hong Kong in 2024 (HK$421,990 and HK$1,265,970 per QALY, respectively).

Abbreviations: TNF, tumor necrosis factor-alpha antagonist; IL-23, interleukin-23 inhibitor; JAKi, Janus kinase inhibitor; GDP, gross domestic product; QALY, quality-adjusted life year; WTP, willingness-to-pay.

Table: Estimated budget impact of moderate-to-severe CD treatment strategies (million HK$, Hong Kong healthcare payer perspective).

The target population comprised patients with moderate-to-severe Crohn’s disease in Hong Kong, identified from the territory-wide electronic medical database managed by Hong Kong Hospital Authority. At model entry in 2024, the baseline prevalent population was 463 patients. The annual incident cohorts entering the budget impact model in 2025–2029 were projected to be 63 per year.

Two market share scenarios were assessed to illustrate a range of possible uptake for each treatment strategy among patients in the treatment pathway.

Scenario 1 (100% uptake per strategy): all entering patients were assigned to the evaluated treatment strategy from Year 1 onward.
Scenario 2 (equal market share): entering patients were allocated according to an equal market share from Year 1 onward. For moderate-to-severe CD, this corresponded to 20% per strategy across five treatment options.

Abbreviations: CD, Crohn’s disease; TNF, tumor necrosis factor-alpha antagonist; IL-23, interleukin-23 inhibitor; JAKi, Janus kinase inhibitor.