Therapeutic Options for Changing the Course of Disease in Generalized Myasthenia Gravis (gMG) and Fiscal Consequences for the Canadian Governments
Author(s)
Zhengyun Qi, BA, MBA1, Ana Teresa Paquete, MSc2, Hans Katzberg, MD FRCPC3, Syed Raza, MSc4, Charles Kassardjian, MD, MSc5, Zaeem Siddiqi, MD, PhD6, Mark Connolly, BA, MSc, PhD7, Nikos Kotsopoulos, MSc, PhD8, Roger Kaprielian, PhD9, Jason Locklin, MSc9, Glenn A. Phillips, PhD10.
1HEOR, argenx, Boston, MA, USA, 2Global Market Access Solutions (GMAS), Mooresville, NC, USA, 3University Health Network, University of Toronto, Toronto, ON, Canada, 4argenx, Milton Keynes, United Kingdom, 5Division of Neurology, Department of Medicine, University of Toronto and St. Michael's Hospital, Li Ka Shing Knowledge Institute, Toronto, ON, Canada, 6University of Alberta, Edmonton, AB, Canada, 7University Medical Center Groningen, Groningen, Netherlands, 8University of Athens MBA, University of Athens, Athens, Greece, 9argenx, Toronto, ON, Canada, 10argenx, Boston, MA, USA.
1HEOR, argenx, Boston, MA, USA, 2Global Market Access Solutions (GMAS), Mooresville, NC, USA, 3University Health Network, University of Toronto, Toronto, ON, Canada, 4argenx, Milton Keynes, United Kingdom, 5Division of Neurology, Department of Medicine, University of Toronto and St. Michael's Hospital, Li Ka Shing Knowledge Institute, Toronto, ON, Canada, 6University of Alberta, Edmonton, AB, Canada, 7University Medical Center Groningen, Groningen, Netherlands, 8University of Athens MBA, University of Athens, Athens, Greece, 9argenx, Toronto, ON, Canada, 10argenx, Boston, MA, USA.
OBJECTIVES: Myasthenia gravis (MG) is a potentially life threatening chronic autoimmune disease that impairs communication between nerves and muscles causing weakening of skeletal muscle often leading to loss of function. MG can impair the ability of people to work effectively and increase their reliance on public support benefits. We utilized a public economic framework that enabled us to explore how MG treatment influences patients’ and caregivers’ economic activity and consequently flows of tax revenues and spending on public support in Canada.
METHODS: Natural history of generalized MG (gMG) was simulated using a multi-state Markov cohort model. Health states were based on MG Activities of Daily Living (MG-ADL) total score. The target population was acetylcholine receptor antibody positive (AChR-Ab+) refractory gMG patients whose symptoms persist despite treatment with conventional therapy. Treatment, disease management costs and broader economic outcomes of patients taking efgartigimod were compared with alternative therapeutic options (i.e., 75% chronic immunoglobulin and 25% conventional therapies alone) for the target population. Canadian public support benefits were based on official government sources.
RESULTS: Improved MG-ADL states predict higher workforce participation, lower rates of disability and less caregiving needs, which result in higher tax revenues for the governments and less public support costs. Compared to alternative therapeutic options, efgartigimod is estimated to yield lifetime fiscal gains of $458,755 that exceed the incremental cost of $291,073. Based on the costs of treatment a fiscal return on investment of 1.6 is achieved over the lifetime of an individual with refractory gMG.
CONCLUSIONS: Improving the outcomes of chronic diseases can offer positive health benefits that transfer into positive fiscal gains for governments. Compared with alternative therapeutic options, efgartigimod generated a positive fiscal return for the Canadian governments with additional savings from disease management, public benefits, and averted tax revenue losses.
METHODS: Natural history of generalized MG (gMG) was simulated using a multi-state Markov cohort model. Health states were based on MG Activities of Daily Living (MG-ADL) total score. The target population was acetylcholine receptor antibody positive (AChR-Ab+) refractory gMG patients whose symptoms persist despite treatment with conventional therapy. Treatment, disease management costs and broader economic outcomes of patients taking efgartigimod were compared with alternative therapeutic options (i.e., 75% chronic immunoglobulin and 25% conventional therapies alone) for the target population. Canadian public support benefits were based on official government sources.
RESULTS: Improved MG-ADL states predict higher workforce participation, lower rates of disability and less caregiving needs, which result in higher tax revenues for the governments and less public support costs. Compared to alternative therapeutic options, efgartigimod is estimated to yield lifetime fiscal gains of $458,755 that exceed the incremental cost of $291,073. Based on the costs of treatment a fiscal return on investment of 1.6 is achieved over the lifetime of an individual with refractory gMG.
CONCLUSIONS: Improving the outcomes of chronic diseases can offer positive health benefits that transfer into positive fiscal gains for governments. Compared with alternative therapeutic options, efgartigimod generated a positive fiscal return for the Canadian governments with additional savings from disease management, public benefits, and averted tax revenue losses.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE527
Topic
Economic Evaluation
Disease
SDC: Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)