Cost‐effectiveness of sutimlimab in cold agglutinin disease

Author:

Ito Satoko1ORCID,Wang Daniel2,Purcell Adriana2,Chetlapalli Karthik2,Lee Alfred I.1,Cuker Adam3,Goshua George14ORCID

Affiliation:

1. Section of Hematology, Department of Internal Medicine Yale School of Medicine New Haven Connecticut USA

2. Yale School of Medicine New Haven Connecticut USA

3. Department of Medicine and Department of Pathology and Laboratory Medicine Perelman School of Medicine, University of Pennsylvania Philadelphia Pennsylvania USA

4. Center for Outcomes Research and Evaluation Yale New Haven Hospital New Haven Connecticut USA

Abstract

AbstractPrimary cold agglutinin disease (CAD) is a rare autoimmune hemolytic anemia caused by cold‐reactive antibodies that bind to red blood cells and lead to complement‐mediated hemolysis. Patients with primary CAD experience the burden of increased health resource utilization and reduced quality of life. The standard‐of‐care (SOC) in patients with primary CAD has included cold avoidance, transfusion support, and chemoimmunotherapy. The use of sutimlimab, a humanized monoclonal antibody that selectively inhibits C1‐mediated hemolysis, was shown to reduce transfusion‐dependence and improve quality of life across two pivotal phase 3 studies, further supported by 2‐year extension data. Using data from the transfusion‐dependent patient population that led to sutimlimab's initial FDA approval, we performed the first‐ever cost‐effectiveness analysis in primary CAD. The projected incremental cost‐effectiveness ratio (ICER) in our Markov model was $2 340 000/QALY, significantly above an upper‐end conventional US willingness‐to‐pay threshold of $150 000/QALY. These results are consistent across scenarios of higher body weight and a pan‐refractory SOC patient phenotype (i.e., treated sequentially with bendamustine‐rituximab, bortezomib, ibrutinib, and eculizumab). No parameter variations in deterministic sensitivity analyses changed our conclusion. In probabilistic sensitivity analysis, SOC was favored over sutimlimab in 100% of 10 000 iterations. Exploratory threshold analyses showed that significant price reduction (>80%) or time‐limited treatment (<18 months) followed by lifelong clinical remission off sutimlimab would allow sutimlimab to become cost‐effective. The impact of sutimlimab on health system costs with longer term follow‐up data merits future study and consideration through a distributional cost‐effectiveness framework.

Funder

Frederick A. DeLuca Foundation

Publisher

Wiley

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3