Economic Evaluations of Anifrolumab for the Management of Patients Affected by Systemic Lupus Erythematosus (SLE) in Italy

OBJECTIVES: The purpose of this study is to evaluate the economic and social impact of introducing anifrolumab as an adjunctive therapy to standard treatment for adult patients with moderate to severe active SLE and autoantibody positivity. This project was unconditionally supported by Astrazeneca S.p.A.

METHODS: A budget impact (BIM) and cost-effectiveness (CEA) model were developed within the analysis to determine the economic-financial impact of introducing anifrolumab. The models were developed from the National Health Service (NHS) perspective. The time horizon considered is 3 years for BIM and lifetime for CEA. In order to characterize parameter uncertainty, two sensitivity analyses were conducted, univariate deterministic and multivariate probabilistic. In addition, to value the social cost associated with the condition, a survey was administered to SLE patients, based on which a cost of illness (COI) analysis was conducted in order to estimate the full cost of the condition.

RESULTS: The BIM identified, assuming the introduction of anifrolumab among the alternatives in the market for the management of SLE, a potential and overall savings over the three years of analysis of €509,313. The CEA results showed that anifrolumab, included as an add-on therapy to standard therapy, is cost-effective compared to the comparator belimumab, both in intravenous and subcutaneous administration, with an ICER of €37,150 and €37,824, respectively. Finally, the COI showed a disease management cost of €2,133 per patient.

CONCLUSIONS: Anifrolumab, included as add-on therapy to the standard, has shown a reduction in disease flare shown up and the ability to manage a wider spectrum of SLE patients, from moderate to severe. Moreover, its implementation could bring savings to the NHS, as evidenced in both the BIM and CEA models. Specifically, this saving, combined with an improvement in patients' quality of life places anifrolumab as a viable alternative to treatments currently on the market.