Assessing Cost-Effectiveness And Key Value Drivers of Adjuvant Triglyceride Lowering Therapy In Management of Patients with A Rare Genetic Syndrome

Abstract

0 1 7 ) A 3 9 9 -A 8 1 1 A555 were elicited from an expert panel of 6 hematologists with the Delphi technique. Unit costs were taken from officially published Greek sources (Ministry of Health, Social Insurance Funds). Utility data were taken from a published UK study. Only direct costs were considered in the analysis and the cost base year was 2016. The time horizon was lifetime and the perspective adopted was the societal. Future costs and outcomes were discounted at 3.5%. Probabilistic sensitivity analysis (PSA) was performed to test robustness of model results. Results: GClb was associated with higher mean costs (€ 24,874) but also with higher life years gained (LYs -5.70) and quality adjusted life years (QALYs) 3.95 versus all comparators. The incremental cost effectiveness ratio (ICER) of GClb versus RClb was estimated at € 15,679 per LY and € 16,614 per QALY gained. The respective ICERs versus Clb, OClb and RBenda were estimated at € 17,258, € 9,587 and € 9,445 per LY and € 19,269, € 9,967 and € 10,026 per QALY gained. PSA showed that the probability of GClb being cost effective at a threshold of € 50,000 per QALY was 98.9%. ConClusions: GClb appears to be a cost effective treatment option versus all comparators in first line treatment of CLL in the Greek health care setting.objeCtives: Idiopathic Pulmonary Fibrosis (IPF) is a rare, progressive disease of unknown aetiology with a median survival of 3 years. To date, nintedanib and pirfenidone are the only antifibrotic agents indicated for the treatment of IPF in Western countries. The aim of this study is to conduct a systematic review of the literature on the cost-effectiveness of these two medicines. Service. Ten studies used a Markov model while 1 other study used a microsimulation model. When compared to best supportive care (BSC), neither nintedanib nor pirfenidone had an incremental costeffectiveness ratio inferior to € 30,000 in any studies except in one which aimed to assess the impact of different models. Seven studies compared nintedanib to pirfenidone. Six of them showed economic dominance of nintedanib over pirfenidone (less costs, more quality-adjusted life years [QALY]), while one showed that pirfenidone was a cost-effective strategy (more QALYs but more costs) compared to nintedanib. ConClusions: Overall, the cost-effectiveness of IPF treatments has been well studied. Nintedanib and pirfenidone have demonstrated important clinical benefits for patients with IPF. Due the lack of alternative treatment, nintedanib and pirfenidone are rarely cost-effective versus BSC. When compared together, nintedanib dominates pirfenidone in most analyses (less costs, more QALYs).