Cost-Effectiveness of Maribavir for Post-Transplant Refractory (With or Without Resistance) Cytomegalovirus Infection in China
Author(s)
Luo Yashuang, MSc1, Wendi Cheng, MSc1, Xiaochen Peng, PhD candidate1, Xin Liu, MSc1, yichun gu, MSc1, Chunlin Jin, PhD1, Sheng Yanan, MSc2, haiyin wang, PhD1;
1Shanghai Health Development Research Center (Shanghai Medical Information Center), Shanghai, China, 2Takeda (China) International Trading Company, Beijing, China
1Shanghai Health Development Research Center (Shanghai Medical Information Center), Shanghai, China, 2Takeda (China) International Trading Company, Beijing, China
Presentation Documents
OBJECTIVES: This study evaluated the cost-effectiveness of maribavir compared with investigator-assigned therapy (IAT) for patients with post-transplant refractory (with or without resistance) (R/R) cytomegalovirus (CMV) infection from the perspective of the Chinese healthcare system.
METHODS: A decision tree combined with a Markov model was developed to assess the costs and health-related outcomes of maribavir versus IAT over a lifetime horizon. During the decision tree stage, patients received maribavir or IAT, transitioning to health states associated with CMV-related complications. The subsequent Markov model included two health states: alive and deceased. Transition probabilities were derived from phase 3 SOLSTICE trial data and published observational studies. Cost inputs, including drug and healthcare costs, were sourced from the Yaozhi database, published literature, and expert consultations. Utilities for health states were elicited from R/R CMV patients through a vignette-based time trade-off study. Costs and outcomes were discounted at an annual rate of 5%. Deterministic and probabilistic sensitivity analyses assessed the uncertainty of base-case results.
RESULTS: Compared with IAT, maribavir provided an additional 0.277 quality-adjusted life-years (QALYs) at an incremental cost of RMB 9,870 (USD 1,385), resulting in an incremental cost-effectiveness ratio (ICER) of RMB 35,652(USD 5,002)/QALY. This ICER is well below the willingness-to-pay (WTP) threshold of one-time GDP per capita (RMB 89,358 [USD 12,538]), indicating that maribavir is cost-effective. Probabilistic sensitivity analysis showed an 78.4% probability of cost-effectiveness at this threshold, supporting the robustness of the base-case results. Sensitivity analyses further confirmed that the ICER remained below the WTP threshold across most tested scenarios.
CONCLUSIONS: Maribavir is a cost-effective treatment for post-transplant patients with R/R CMV in China, particularly after its inclusion in the National Reimbursement Drug List. These findings support its use in clinical practice and provide evidence for resource allocation decisions to optimize health outcomes for this patient population.
METHODS: A decision tree combined with a Markov model was developed to assess the costs and health-related outcomes of maribavir versus IAT over a lifetime horizon. During the decision tree stage, patients received maribavir or IAT, transitioning to health states associated with CMV-related complications. The subsequent Markov model included two health states: alive and deceased. Transition probabilities were derived from phase 3 SOLSTICE trial data and published observational studies. Cost inputs, including drug and healthcare costs, were sourced from the Yaozhi database, published literature, and expert consultations. Utilities for health states were elicited from R/R CMV patients through a vignette-based time trade-off study. Costs and outcomes were discounted at an annual rate of 5%. Deterministic and probabilistic sensitivity analyses assessed the uncertainty of base-case results.
RESULTS: Compared with IAT, maribavir provided an additional 0.277 quality-adjusted life-years (QALYs) at an incremental cost of RMB 9,870 (USD 1,385), resulting in an incremental cost-effectiveness ratio (ICER) of RMB 35,652(USD 5,002)/QALY. This ICER is well below the willingness-to-pay (WTP) threshold of one-time GDP per capita (RMB 89,358 [USD 12,538]), indicating that maribavir is cost-effective. Probabilistic sensitivity analysis showed an 78.4% probability of cost-effectiveness at this threshold, supporting the robustness of the base-case results. Sensitivity analyses further confirmed that the ICER remained below the WTP threshold across most tested scenarios.
CONCLUSIONS: Maribavir is a cost-effective treatment for post-transplant patients with R/R CMV in China, particularly after its inclusion in the National Reimbursement Drug List. These findings support its use in clinical practice and provide evidence for resource allocation decisions to optimize health outcomes for this patient population.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE305
Topic
Economic Evaluation
Disease
SDC: Infectious Disease (non-vaccine)