Curcumin-QingDai Combination for Active Ulcerative Colitis: A Cost-Effectiveness Analysis

Objectives: A combination of 2 herbal compounds, curcumin and QingDai (CurQD), has recently been proposed as an effective treatment for patients with active ulcerative colitis (UC), based on both randomized controlled and real-world evidence. However, no cost-effectiveness analysis for this nutraceutical is currently available. Methods: A Markov model was generated to simulate the progression of patients with moderate-to-severe UC, by separate analysis for a cohort of advanced therapy-naïve and advanced therapy-experienced patients. Medication costs were derived from the published average wholesale price in the United States. Efficacy data were modeled by synthesizing efficacy reports from randomized, placebo-controlled trials and real-world cohort studies of all US Food and Drug Administration-approved drugs for UC, and each was compared with CurQD. The model used a 54-week time horizon. A threshold of $50 000 per quality-adjusted life-year (QALY) was chosen, and a 1-way sensitivity analysis was performed to assess the robustness of the study. Results: The comparison of CurQD with the US Food and Drug Administration-approved advanced therapies for UC yielded an estimated incremental cost-effectiveness ratio of over 200 000$/QALY for all comparisons. Differences ranged from −0.05 to a slight gain of 0.07 QALY in bio-experienced patients and from −0.1 to 0.04 QALY in bio-naïve patients. The 1-way sensitivity analysis proved the robustness of the study. Conclusion: This analysis suggests that the markedly reduced cost and demonstrated efficacy of CurQD provide a significant cost-effectiveness benefit over advanced therapies for active UC, including over anti-tumor necrosis factor biosimilars.