Integration of Environmental Considerations in Economic Evaluations: Significant Shift or Token Gesture? Insights From Severe Asthma Treatments
Author(s)
Loïg Gaugain, MSc1, Aurélie Godbout, MD, MSc2, Raphaëlle Boutin, PharmD, MSc2.
1Institut national d'excellence en santé et en services sociaux, Montreal, QC, Canada, 2Institut national d'excellence en santé et en services sociaux, Quebec, QC, Canada.
1Institut national d'excellence en santé et en services sociaux, Montreal, QC, Canada, 2Institut national d'excellence en santé et en services sociaux, Quebec, QC, Canada.
Presentation Documents
OBJECTIVES: Health Technology Assessment agencies increasingly aim to incorporate environmental considerations into their value appraisal processes. Despite their advantages, integrated evaluation approaches remain rarely used due to their complexity and the additional data required. This study explores the feasibility and relevance of using an integrated evaluation approach within a cost-utility analysis for severe asthma treatments.
METHODS: A cost-utility analysis was conducted comparing tezepelumab plus standard of care to standard of care alone, using the published model from ICER Analytics. Model inputs were derived from ICER’s base case analysis, with the addition of the monetary value of CO2 emissions related to treatments, emergency department visits and hospitalizations. CO2 emissions were sourced from the literature and converted into monetary units using the social cost of carbon (SCC) as determined by the US Interagency Working Group on Social Cost of Greenhouse Gases. Both average and 95th percentile estimates of the SCC were tested, and the results were compared to ICER’s base case analysis excluding environmental considerations.
RESULTS: Compared to the base case analysis, the integration of environmental impacts resulted in decreased incremental costs ranging from 87$ to 262$ using the average and 95th percentile estimates of SCC, respectively. This corresponds to 1.7 to 5.1 tons of CO2 that could be saved by adding tezepelumab to the standard of care, mainly through the reduction of emissions related to hospitalizations. However, the overall impact on the incremental cost-effectiveness ratio remained minimal (<1%).
CONCLUSIONS: This study shows the feasibility of incorporating environmental impacts as costs into economic evaluations for severe asthma treatments, provided that such data is available. While the overall impact on cost-effectiveness is minimal, quantifying the CO2 emissions saved or added by the evaluated treatment provides valuable insights. Further research is needed to determine the most appropriate methods and preferred sources for integrating environmental considerations in economic evaluations.
METHODS: A cost-utility analysis was conducted comparing tezepelumab plus standard of care to standard of care alone, using the published model from ICER Analytics. Model inputs were derived from ICER’s base case analysis, with the addition of the monetary value of CO2 emissions related to treatments, emergency department visits and hospitalizations. CO2 emissions were sourced from the literature and converted into monetary units using the social cost of carbon (SCC) as determined by the US Interagency Working Group on Social Cost of Greenhouse Gases. Both average and 95th percentile estimates of the SCC were tested, and the results were compared to ICER’s base case analysis excluding environmental considerations.
RESULTS: Compared to the base case analysis, the integration of environmental impacts resulted in decreased incremental costs ranging from 87$ to 262$ using the average and 95th percentile estimates of SCC, respectively. This corresponds to 1.7 to 5.1 tons of CO2 that could be saved by adding tezepelumab to the standard of care, mainly through the reduction of emissions related to hospitalizations. However, the overall impact on the incremental cost-effectiveness ratio remained minimal (<1%).
CONCLUSIONS: This study shows the feasibility of incorporating environmental impacts as costs into economic evaluations for severe asthma treatments, provided that such data is available. While the overall impact on cost-effectiveness is minimal, quantifying the CO2 emissions saved or added by the evaluated treatment provides valuable insights. Further research is needed to determine the most appropriate methods and preferred sources for integrating environmental considerations in economic evaluations.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE435
Topic
Economic Evaluation
Topic Subcategory
Novel & Social Elements of Value
Disease
SDC: Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)