COST-EFFECTIVENESS OF VELIGROTUG VERSUS TEPROTUMUMAB FOR MODERATE-TO-SEVERE THYROID EYE DISEASE IN THE UNITED STATES
Author(s)
Zhengxuan Li1, Cristina Weng, MD2, Hua Chen, PhD, MD3, Moosa Tatar, PhD3;
1University of Houston, PhD student, Houston, TX, USA, 2Baylor College of Medicine, Houston, TX, USA, 3University of Houston, Houston, TX, USA
1University of Houston, PhD student, Houston, TX, USA, 2Baylor College of Medicine, Houston, TX, USA, 3University of Houston, Houston, TX, USA
OBJECTIVES: To evaluate the cost-effectiveness of veligrotug (VRDN-001), an investigational insulin-like growth factor-1 receptor (IGF-1R) inhibitor, compared with teprotumumab for the treatment of moderate-to-severe thyroid eye disease (TED) from a US healthcare payer perspective.
METHODS: A decision-analytic model was developed in TreeAge Pro Healthcare 2025 to compare veligrotug with teprotumumab over a 1-year time horizon corresponding to a complete treatment course. Clinical efficacy inputs were derived from the OPTIC and THRIVE-2 phase 3 trials and defined by proptosis response (at least 2 mm reduction). Health outcomes were measured in quality-adjusted life-years (QALYs). Teprotumumab costs were based on 2025 Medicare reimbursement rates, while veligrotug costs were evaluated across plausible per-course price scenarios due to lack of commercial pricing. Infusion administration costs were included. Cost-effectiveness was assessed using willingness-to-pay (WTP) thresholds of USD 150,000 and USD 500,000 per QALY. Incremental net monetary benefit (NMB) was the primary outcome. Deterministic one-way sensitivity analyses were conducted to assess model robustness.
RESULTS: In the base-case analysis, veligrotug was associated with lower total costs (USD 309,139 vs. USD 386,000) and higher effectiveness (0.0213 vs. 0.0194 QALYs) compared with teprotumumab, indicating economic dominance under assumed pricing conditions. One-way sensitivity analyses identified total veligrotug treatment cost as the primary driver of incremental NMB, whereas variation in clinical parameters had limited impact. Veligrotug remained cost-saving when its total per-course price was below approximately USD 395,000-400,000. Results were consistent when applying a higher WTP threshold of USD 500,000 per QALY.
CONCLUSIONS: Under plausible pricing assumptions, veligrotug may represent a cost-effective and potentially cost-saving alternative to teprotumumab for moderate-to-severe TED. Final pricing and real-world effectiveness data will be critical to confirming its economic value following regulatory approval.
METHODS: A decision-analytic model was developed in TreeAge Pro Healthcare 2025 to compare veligrotug with teprotumumab over a 1-year time horizon corresponding to a complete treatment course. Clinical efficacy inputs were derived from the OPTIC and THRIVE-2 phase 3 trials and defined by proptosis response (at least 2 mm reduction). Health outcomes were measured in quality-adjusted life-years (QALYs). Teprotumumab costs were based on 2025 Medicare reimbursement rates, while veligrotug costs were evaluated across plausible per-course price scenarios due to lack of commercial pricing. Infusion administration costs were included. Cost-effectiveness was assessed using willingness-to-pay (WTP) thresholds of USD 150,000 and USD 500,000 per QALY. Incremental net monetary benefit (NMB) was the primary outcome. Deterministic one-way sensitivity analyses were conducted to assess model robustness.
RESULTS: In the base-case analysis, veligrotug was associated with lower total costs (USD 309,139 vs. USD 386,000) and higher effectiveness (0.0213 vs. 0.0194 QALYs) compared with teprotumumab, indicating economic dominance under assumed pricing conditions. One-way sensitivity analyses identified total veligrotug treatment cost as the primary driver of incremental NMB, whereas variation in clinical parameters had limited impact. Veligrotug remained cost-saving when its total per-course price was below approximately USD 395,000-400,000. Results were consistent when applying a higher WTP threshold of USD 500,000 per QALY.
CONCLUSIONS: Under plausible pricing assumptions, veligrotug may represent a cost-effective and potentially cost-saving alternative to teprotumumab for moderate-to-severe TED. Final pricing and real-world effectiveness data will be critical to confirming its economic value following regulatory approval.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE79
Topic
Economic Evaluation
Topic Subcategory
Thresholds & Opportunity Cost
Disease
SDC: Sensory System Disorders (Ear, Eye, Dental, Skin), SDC: Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)