Cost Minimization Of 10% Intravenous Immunoglobulin Against Other Intravenous Immunoglobulin For Treating Primary Inmunodeficiencies

Abstract

A433 20 weeks) vs. OnaBTX administered at fixed intervals (minimum 12, maximum 20 weeks); a 5-year horizon time was used. It was assumed that patients experiment a re-emergence of symptoms at some point after administration of toxins. Utilities were extracted from a published study in patients with focal dystonia. Costs (drugs acquisition and administration) were based on Spanish public databases. Efficiency outcome was expressed as the Incremental Cost Effectiveness Ratio (ICER). Deterministic and probabilistic sensitivity analyses were performed. Results: In the management of BL, patients treated with IncoBTX at flexible intervals (cost: € 3742) showed symptoms during 22.12 weeks less than those treated with OnaBTX at fixed intervals (€ 3366), leading to a QALY gain of 0.0276. In CD, patients with IncoBTX (cost: € 6673) showed symptoms during 21.34 weeks less than OnaBTX (cost: € 6419), resulting in a QALY gain of 0.0610. Estimated ICER was 13,576 and 4,158 € /QALY in BL and CD respectively ConClusions: The treatment of BL and CD with IncoBTX at flexible intervals determined by the patient needs clinically confirmed is an efficient therapeutic alternative compared to the fixed administration of OnaTBX in Spain. Patients treated at flexible intervals had fewer weeks experiencing symptoms compared to the patients treated at minimum 12-weeks intervals.objeCtives: Incobotulinumtoxin-A (Xeomin®) is a formulation of botulinum neurotoxin type A (BoNT/A) that is free of complexing proteins. The advantages of incobotulinumtoxin-A include flexible treatment intervals determined by clinically confirmed patient needs. The objective of this study was to assess the cost-effectiveness of incobotulinumtoxin-A administered with flexible treatment intervals compared to a scenario where incobotulinumtoxin-A was given at fixed doses every 12 weeks in blepharospasm (BLEPH) and cervical dystonia (CD) from the Australian healthcare providers' perspective. Methods: A Markov state transition model was developed to perform a cost-utility analysis (CUA). The CUA compared incobotulinumtoxin-A treatment, given at minimum intervals of 6 weeks and maximum intervals of 20 weeks, with incobotulinumtoxin-A treatment given at fixed 12 week intervals. The Markov model consisted of three health states and followed patients in weekly cycles for one year. Only direct healthcare costs associated with the acquisition and administration of BoNT/A's were included. Utility values were derived from a prospective, open-labelled cohort study. The primary outcome measure was the incremental cost per quality-adjusted life year (QALY). Univariate and probabilistic sensitivity analyses were conducted. Results: Incobotulinumtoxin-A flexible dosing was cost-effective compared to incobotulinumtoxin-A fixed 12 week dosing with an incremental cost per QALY gained of $20,696 in BLEPH and $4,243 in CD. Results held under sensitivity analyses. ConClusions: Incobotulinumtoxin-A administered at flexible treatment intervals, determined by patient needs, represents a more ...