A projected cost-utility analysis of avacopan for the treatment of antineutrophil cytoplasmic antibody-associated vasculitis in Spain
Macía, Manuel (Hospital Universitario Nuestra Señora de Candelaria (Santa Cruz de Tenerife))
Díaz Encarnación, Montserrat Mercedes (Institut de Recerca Sant Pau)
Solans, Roser (Hospital Universitari Vall d'Hebron)
Mallol, Elisenda Pomares (PharmaLex)
Castells, Alejandra (PharmaLex)
Escribano, Cristina (CSL Vifor)
de Arellano, Antonio Ramírez (CSL Vifor)
Universitat Autònoma de Barcelona

Data:	2024
Resum:	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. 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. 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. Avacopan is a cost-effective option for patients with severe, active AAV compared to GC in Spain.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Avacopan ; Competitive C5a receptor antagonist ; Cost-utility analysis ; Granulomatosis with polyangiitis ; Microscopic polyangiitis ; Vasculitis
Publicat a:	Expert Review of Pharmacoeconomics and Outcomes Research, Vol. 24 Núm. 2 (2024) , p. 227-235, ISSN 1744-8379

DOI: 10.1080/14737167.2023.2297790
PMID: 38126738

10 p, 1.6 MB

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