Budget Impact Analysis of Introducing Benralizumab for the Treatment of Eosinophilic Granulomatosis With Polyangiitis: A European Perspective

OBJECTIVES: To estimate the budget impact of introducing benralizumab for the treatment of eosinophilic granulomatosis with polyangiitis (EGPA) in Europe.

METHODS: A budget impact model was developed to predict the five-year economic impact of introducing benralizumab for the treatment of patients with EGPA in Europe. Market share distribution was based on commercial forecasting on the uptake of benralizumab and mepolizumab within Europe. The MANDARA trial (NCT04157348) was used to extrapolate the rate of relapses for benralizumab and mepolizumab; the MIRRA study (NCT02020889) was used for standard of care. Discontinuation of biologic treatments due to lack of clinical response was evaluated one year after initiation of treatment. The treatment-dependent cumulative dose of oral corticosteroids (OCS) was captured year-on-year to predict the incidence of associated clinical outcomes. Healthcare resource use associated with relapse was sourced from the UK Clinical Practice Research Datalink. Direct medical costs for drug acquisition and OCS-related adverse events were sourced from UK-based sources and literature. Costs were monetised using UK unit costs and converted to Euros using conversion factors derived from purchasing power parities.

RESULTS: The introduction of benralizumab was predicted to have a three- and five-year cumulative budget saving of €412 thousand and €1.5 million, respectively. The five-year incidence of relapses were predicted to be similar in a world with and without benralizumab. The maintenance OCS sparing effects of benralizumab were predicted to result in modest cost offsets. The three- and five-year cumulative budget impact was most sensitive to the acquisition costs of benralizumab and mepolizumab; the probability of responding to biologic treatments was also a significant driver of outcomes.

CONCLUSIONS: The incorporation of benralizumab into European healthcare systems would provide cost reductions for the healthcare payer, primarily driven through the reduced acquisition costs of benralizumab compared with mepolizumab for the treatment of EGPA.