Jas Bindra1, Ishveen Chopra2, Kyle Hayes3, John Niewoehner3, Mary Panaccio3, George J Wan4. 1. Falcon Research Group, North Potomac, MD, USA. 2. Manticore Consultancy, Bethesda, MD, USA. 3. Mallinckrodt Pharmaceuticals, 53 Frontage Road, Hampton, NJ, 08827, USA. 4. Mallinckrodt Pharmaceuticals, 53 Frontage Road, Hampton, NJ, 08827, USA. george.wan@mnk.com.
Abstract
INTRODUCTION: Despite current standard of care (SoC), there is an unmet need for the treatment of active systemic lupus erythematosus (SLE). The study assessed the cost-effectiveness of Acthar® Gel (repository corticotropin injection) versus SoC treatment in patients with active, moderate-to-severe SLE from the US payer and societal perspectives over 2 and 3 years. METHODS: Cost-effectiveness model was developed using a probabilistic cohort-level state-transition approach. Patients received Acthar Gel in an exacerbation state, and the outcomes were assessed at the end of a 3-month cycle for response achievement based on the probability of treatment success with Acthar Gel. Patients may sustain the response or experience an exacerbation. For the base case scenario, moderate-to-severe SLE was defined as British Isles Lupus Assessment Group (BILAG)-2004 ≥ 20 or SLE Disease Activity Index 2000 (SLEDAI-2K) ≥ 10 and clinical response was based on SLE responder index (SRI)-4. Clinical response, productivity loss, and utility were derived from a phase 4 SLE trial; cost and disutility estimates were sourced from the literature. RESULTS: From a payer perspective, Acthar Gel versus SoC resulted in an incremental cost-effectiveness ratio (ICER) of $133,110 per quality-adjusted life-year (QALY) and $94,818 per QALY over 2 and 3 years, respectively. From a societal perspective, Acthar Gel versus SoC results in an ICER of $70,827 per QALY and $32,525 per QALY over 2 and 3 years, respectively. Results from the sensitivity and scenario analyses are consistent with those of the base case model. CONCLUSIONS: Acthar Gel is a cost-effective, value-based treatment option for appropriate patients with moderate-to-severe SLE at a willingness-to-pay threshold of $150,000 over 2-3 years from the US payer and societal perspectives. Acthar Gel results in the reduction of direct medical and indirect costs.
INTRODUCTION: Despite current standard of care (SoC), there is an unmet need for the treatment of active systemic lupus erythematosus (SLE). The study assessed the cost-effectiveness of Acthar® Gel (repository corticotropin injection) versus SoC treatment in patients with active, moderate-to-severe SLE from the US payer and societal perspectives over 2 and 3 years. METHODS: Cost-effectiveness model was developed using a probabilistic cohort-level state-transition approach. Patients received Acthar Gel in an exacerbation state, and the outcomes were assessed at the end of a 3-month cycle for response achievement based on the probability of treatment success with Acthar Gel. Patients may sustain the response or experience an exacerbation. For the base case scenario, moderate-to-severe SLE was defined as British Isles Lupus Assessment Group (BILAG)-2004 ≥ 20 or SLE Disease Activity Index 2000 (SLEDAI-2K) ≥ 10 and clinical response was based on SLE responder index (SRI)-4. Clinical response, productivity loss, and utility were derived from a phase 4 SLE trial; cost and disutility estimates were sourced from the literature. RESULTS: From a payer perspective, Acthar Gel versus SoC resulted in an incremental cost-effectiveness ratio (ICER) of $133,110 per quality-adjusted life-year (QALY) and $94,818 per QALY over 2 and 3 years, respectively. From a societal perspective, Acthar Gel versus SoC results in an ICER of $70,827 per QALY and $32,525 per QALY over 2 and 3 years, respectively. Results from the sensitivity and scenario analyses are consistent with those of the base case model. CONCLUSIONS: Acthar Gel is a cost-effective, value-based treatment option for appropriate patients with moderate-to-severe SLE at a willingness-to-pay threshold of $150,000 over 2-3 years from the US payer and societal perspectives. Acthar Gel results in the reduction of direct medical and indirect costs.
Authors: Patricia Katz; George J Wan; Paola Daly; Lauren Topf; Erin Connolly-Strong; Ryan Bostic; Michael L Reed Journal: Qual Life Res Date: 2020-07-18 Impact factor: 4.147
Authors: Irene B Murimi-Worstell; Dora H Lin; Hong Kan; Jonothan Tierce; Xia Wang; Henk Nab; Barnabas Desta; G Caleb Alexander; Edward R Hammond Journal: J Rheumatol Date: 2020-07-01 Impact factor: 4.666
Authors: Bingcao Wu; Gaurav Deshpande; Tao Gu; Breanna Popelar; Michael Philbin; George J Wan Journal: J Med Econ Date: 2017-08-11 Impact factor: 2.448
Authors: Peter M Izmirly; Hilary Parton; Lu Wang; W Joseph McCune; S Sam Lim; Cristina Drenkard; Elizabeth D Ferucci; Maria Dall'Era; Caroline Gordon; Charles G Helmick; Emily C Somers Journal: Arthritis Rheumatol Date: 2021-04-23 Impact factor: 15.483