A projected cost-utility analysis of avacopan for the treatment of antineutrophil cytoplasmic antibody-associated vasculitis in Spain.
| Autor: | Macía M; Nephrology Service, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain., Díaz-Encarnación M; Nephrology Service, Fundació Puigvert, Barcelona, Spain., Solans-Laqué R; Internal Medicine Department, Hospital Valle de Hebrón, Barcelona, Spain., Mallol EP; Market Access, PharmaLex, Barcelona, Spain., Castells AG; Market Access, PharmaLex, Barcelona, Spain., Escribano C; Medical Department, CSL Vifor, Barcelona, Spain., de Arellano AR; HEOR, CSL Vifor, Zürich, Switzerland. |
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| Jazyk: | angličtina |
| Zdroj: | Expert review of pharmacoeconomics & outcomes research [Expert Rev Pharmacoecon Outcomes Res] 2024 Feb; Vol. 24 (2), pp. 227-235. Date of Electronic Publication: 2024 Jan 25. |
| DOI: | 10.1080/14737167.2023.2297790 |
| Abstrakt: | Background: Antineutrophil cytoplasmic antibody-associated vasculitis (AAV) are rare autoimmune diseases characterized by inflammation of blood vessels. This study aimed to assess the cost-utility of avacopan in combination with rituximab (RTX) or cyclophosphamide (CYC) compared with glucocorticoids (GC) for the treatment of severe, active AAV in Spain. Methods: A 9-state Markov model was designed to reflect the induction of remission and sustained remission of AAV over a lifetime horizon. Clinical data and utility values were mainly obtained from the ADVOCATE trial, and costs (€ 2022) were sourced from national databases. Quality-adjusted life years (QALYs), and incremental cost-utility ratio (ICUR) were evaluated. An annual discount rate of 3% was applied. Sensitivity analyses were performed to examine the robustness of the results. Results: Avacopan yielded an increase in effectiveness (6.52 vs. 6.17 QALYs) and costs (€16,009) compared to GC, resulting in an ICUR of €45,638 per additional QALY gained. Avacopan was associated with a lower incidence of end-stage renal disease (ESRD), relapse and hospitalization-related adverse events. Sensitivity analyses suggested that the model outputs were robust and that the progression to ESRD was a driver of ICUR. Conclusions: Avacopan is a cost-effective option for patients with severe, active AAV compared to GC in Spain. |
| Databáze: | MEDLINE |
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