Cost-Effectiveness Analysis of Innovative Therapies for Patients with Non-Alcoholic Fatty Liver Disease.

Autor: Pochopien M; Assignity, Wadowicka 8a, 30-415 Krakow, Poland., Dziedzic JW; Assignity, Wadowicka 8a, 30-415 Krakow, Poland., Aballea S; InovIntell, 3023GJ Rotterdam, Zuid-Holland, The Netherlands., Clay E; Clever-Access, 53 Avenue Montaigne, 75008 Paris, France., Zerda I; Assignity, Wadowicka 8a, 30-415 Krakow, Poland., Toumi M; InovIntell, 215 rue du Faubourg St Honoré, 75008 Paris, France., Borissov B; Prescriptia, 28, Hristo Botev Blvd., 1517 Sofia, Bulgaria.
Jazyk: angličtina
Zdroj: Journal of market access & health policy [J Mark Access Health Policy] 2024 Apr 02; Vol. 12 (2), pp. 35-57. Date of Electronic Publication: 2024 Apr 02 (Print Publication: 2024).
DOI: 10.3390/jmahp12020005
Abstrakt: Objective: Currently there are no disease-specific approved therapies for non-alcoholic fatty liver (NAFL) and non-alcoholic steatohepatitis (NASH); however, several treatments are under development. This study aimed to estimate the cost-effectiveness of hypothetical innovative therapies compared with lifestyle intervention alone and combined with pioglitazone, and assess the health economic consequences of their future availability for patients.
Methods: A Markov cohort model was developed, considering fourteen disease health states and one absorbing state representing death. Transition probabilities, costs, utilities, and treatment efficacy were based on published data and assumptions. Four treatment strategies were considered, including two existing therapies (lifestyle intervention, small molecule treatment) and two hypothetical interventions (biological and curative therapy). The analysis was performed from the US third-party payer perspective.
Results: The curative treatment with the assumed efficacy of 70% of patients cured and assumed price of $500,000 was the only cost-effective option. Although it incurred higher costs (a difference of $188,771 vs. lifestyle intervention and $197,702 vs. small molecule), it generated more QALYs (a difference of 1.58 and 1.38 QALYs, respectively), resulting in an ICER below the willingness-to-pay threshold of $150,000 per QALY. The sensitivity analyses showed that the results were robust to variations in model parameters.
Conclusions: This study highlighted the potential benefits of therapies aimed at curing a disease rather than stopping its progression. Nonetheless, each of the analyzed therapies could be cost-effective compared with lifestyle intervention at a relatively high price.
Competing Interests: Conflicts of InterestM.P., I.Z. and J.W.D. are employed by company Assignity; S.A. and M.T. are employed by company InovIntell; E.C. is employed by company Clever-Access; B.B. is employed by company Prescriptia. Authors declare that the research was conducted in the absence of any commercial or financial relationships that could be constructed as a potential conflict of interest.
(© 2024 by the authors.)
Databáze: MEDLINE
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