Improving Precision of Societal Budget Impact Analysis of Emicizumab Delivery Options in France: Insights From the Hemivalue Study Using Real-World Data From the PASO DOBLE DEMI Study
Speaker(s)
Leleu H1, Fraticelli L2, Ajjouri R3, Touvron G3, Bergougnoux L3, Chamouard V4
1Public Health Expertise, Paris, France, 2University Claude Bernard Lyon 1, University of Lyon, Lyon, France, 3Roche, Boulogne billancourt, 75, France, 4Louis Pradel Hospital, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron, France
Presentation Documents
OBJECTIVES: Emicizumab, a prophylactic treatment for severe hemophilia A (HA), has traditionally been dispensed through hospital pharmacies (HP) in France. Since 2021, it is also available in community pharmacies (CP). This study aims to compare the budget impact (BI) of HP and CP delivery of emicizumab, incorporating real-world data (RWD) to improve previous results. METHODS: An existing BI model was updated with the PASO DOBLE DEMI study results to estimate time and costs associated with annual administration of emicizumab from the patient's perspective. Costs included transportation to and from the pharmacy, accounting for average distances and transportation modes, as well as wage losses due to time spent traveling and waiting for drug delivery. Two scenarios were examined: HP availability only and HP and CP availability (with an estimated 60% of patients utilizing CP in 2022 in the RWD). The updated outcomes were compared to those derived from previous assumptions. RESULTS: On average, patients spent 26.0 hours annually obtaining emicizumab from HP, compared to 4.3 hours from CP, resulting in a time saving of 21.7 hours when contrasted with the previously estimated 39.9 hours. The annual cost to patients was €342 for HP, compared to €323, and €20 for CP deliveries, compared to €19. Incorporating RWD facilitated additional analyses, including the examination of access inequalities because of geographic disparities: for patients residing more than 30 minutes from an HP, these costs represented 4.1% of their disposable income compared to 0.2% for CP. CONCLUSIONS: The availability of emicizumab in CP significantly reduces the financial and logistical burdens for HA patients and carers compared to dispensation in HP, as substantiated by patients’ perception in the PASO DOBLE DEMI results. Integrating RWD into the BI model enhances precision and contextual relevance, reinforcing the advantages of CP delivery for HA treatment for patients and carers.
Code
PCR156
Topic
Economic Evaluation, Health Policy & Regulatory
Topic Subcategory
Budget Impact Analysis, Health Disparities & Equity, Work & Home Productivity - Indirect Costs
Disease
Rare & Orphan Diseases