Cost-Effectiveness Analysis of Momelotinib for the Treatment of Adult Patients With Myelofibrosis and Anemia in Canada
Author(s)
Justin D. Riemer, MBiotech1, Michael Groff, BSc, MSc2, Angie Raad, MSc2, Molly Purser, MBA, PhD3, Yevgeniy SAMYSHKIN, MSc4, Shiyuan Zhang, BSc, MSc3;
1GSK, Mississagua, ON, Canada, 2Cytel, Toronto, ON, Canada, 3GSK, Philadelphia, PA, USA, 4GSK, London, United Kingdom
1GSK, Mississagua, ON, Canada, 2Cytel, Toronto, ON, Canada, 3GSK, Philadelphia, PA, USA, 4GSK, London, United Kingdom
Presentation Documents
OBJECTIVES: Momelotinib, a JAK inhibitor (JAKi), was approved by Health Canada in November 2024 for the treatment of adults with myelofibrosis who have moderate to severe anemia. A cost-effectiveness model was developed to evaluate costs and health outcomes (life-years [LYs], quality-adjusted life-years [QALYs]) associated with momelotinib vs ruxolitinib or best available therapy (BAT) in JAKi-naive and -experienced patients, respectively.
METHODS: The Markov model used a Canadian healthcare payer perspective over a lifetime horizon (33 Years), discounting costs and outcomes in 1.5% per annum, for patients with myelofibrosis and hemoglobin (Hb) <10 g/dL. Health states included transfusion independent (TI; no red blood cell [RBC] transfusions and Hb >8 g/dL in the prior 12 weeks), transfusion dependent (TD; ≥4 RBC units or Hb <8 g/dL in the prior 8 weeks), transfusion requiring (not TI/TD), and death; transition probabilities were based on the SIMPLIFY-1 (JAKi-naive) and SIMPLIFY-2 (JAKi-experienced) trials. Costs (2024 CAD$) included drug acquisition/administration, subsequent treatment, adverse events, monitoring, transfusions, and terminal care. Utility values were calculated from EQ-5D-5L responses (Canadian tariff) in SIMPLIFY-1 and SIMPLIFY-2. The base case included a pooled JAKi-naive/experienced population. Scenario analyses, including subpopulations based on JAKi exposure, were also conducted.
RESULTS: In the probabilistic base case for patients with Hb <10 g/dL, momelotinib was less costly (CAD$ 82,551 total savings) and more effective (0.058 incremental LYs; 0.043 incremental QALYs) vs ruxolitinib/BAT. Patients spent more time in the TI state with momelotinib (LYs, 1.36 vs 1.15; QALYs, 1.03 vs 0.88). All scenario analyses were aligned in favor of momelotinib.
CONCLUSIONS: These results suggest that momelotinib is cost-effective vs ruxolitinib/BAT for Canadian patients with myelofibrosis and anemia. Momelotinib-treated patients spent more time in the TI state, which was associated with improved QALYs and may provide cost savings from a Canadian healthcare payer perspective.
Funding: GSK (Study ID: 222051)
METHODS: The Markov model used a Canadian healthcare payer perspective over a lifetime horizon (33 Years), discounting costs and outcomes in 1.5% per annum, for patients with myelofibrosis and hemoglobin (Hb) <10 g/dL. Health states included transfusion independent (TI; no red blood cell [RBC] transfusions and Hb >8 g/dL in the prior 12 weeks), transfusion dependent (TD; ≥4 RBC units or Hb <8 g/dL in the prior 8 weeks), transfusion requiring (not TI/TD), and death; transition probabilities were based on the SIMPLIFY-1 (JAKi-naive) and SIMPLIFY-2 (JAKi-experienced) trials. Costs (2024 CAD$) included drug acquisition/administration, subsequent treatment, adverse events, monitoring, transfusions, and terminal care. Utility values were calculated from EQ-5D-5L responses (Canadian tariff) in SIMPLIFY-1 and SIMPLIFY-2. The base case included a pooled JAKi-naive/experienced population. Scenario analyses, including subpopulations based on JAKi exposure, were also conducted.
RESULTS: In the probabilistic base case for patients with Hb <10 g/dL, momelotinib was less costly (CAD$ 82,551 total savings) and more effective (0.058 incremental LYs; 0.043 incremental QALYs) vs ruxolitinib/BAT. Patients spent more time in the TI state with momelotinib (LYs, 1.36 vs 1.15; QALYs, 1.03 vs 0.88). All scenario analyses were aligned in favor of momelotinib.
CONCLUSIONS: These results suggest that momelotinib is cost-effective vs ruxolitinib/BAT for Canadian patients with myelofibrosis and anemia. Momelotinib-treated patients spent more time in the TI state, which was associated with improved QALYs and may provide cost savings from a Canadian healthcare payer perspective.
Funding: GSK (Study ID: 222051)
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE157
Topic
Economic Evaluation
Disease
SDC: Oncology