ESTIMATING THE BENEFITS FOR GOVERNMENT FROM IMPROVED OUTCOMES FOR PEOPLE WITH GENERALIZED MYASTHENIA GRAVIS (GMG) IN THE UNITED STATES: A FISCAL ANALYTIC FRAMEWORK
Author(s)
Ana Teresa Paquete, MSc1, Stephen J. Tearoe, MA2, Mark P. Connolly, BA, MSc, PhD3, Cynthia Qi, BA, MBA4, Glenn A. Phillips, PhD4, Nikos Kotsopoulos, MSc, PhD5, Lou Garrison, PhD6;
1Global Market Access Solutions (GMAS), Health Economics, Mooresville, NC, USA, 2Global Market Access Solutions, Ottawa, ON, Canada, 3Global Market Access Solutions LLC, Groningen, Netherlands, 4Argenx, Boston, MA, USA, 5Global Market Access Solutions (GMAS), Mooresville, NC, USA, 6The Comparative Health Outcomes, Policy, and Economics (CHOICE) Institute, Seattle, WA, USA
1Global Market Access Solutions (GMAS), Health Economics, Mooresville, NC, USA, 2Global Market Access Solutions, Ottawa, ON, Canada, 3Global Market Access Solutions LLC, Groningen, Netherlands, 4Argenx, Boston, MA, USA, 5Global Market Access Solutions (GMAS), Mooresville, NC, USA, 6The Comparative Health Outcomes, Policy, and Economics (CHOICE) Institute, Seattle, WA, USA
OBJECTIVES: The economic impact of living with gMG extends beyond the healthcare sector and direct effects on patients' health. Effective treatments can prevent patients and caregivers from reducing their workforce participation with expected gains in earnings and consequent government tax revenue, and reduced government public benefit payments. This research evaluates the projected lifetime economic impact of efgartigimod for treatment of acetylcholine receptor antibody positive (AChR-Ab+) generalized myasthenia gravis (gMG) on governmental accounts in the United States.
METHODS: The lifetime natural course of gMG was modelled using a Markov cohort approach, with health states defined by the MG Activities of Daily Living (MG-ADL) scores. A cohort of patients initiating treatment with chronic intravenous immunoglobulin (IVIg) or efgartigimod and their informal caregivers are compared to a cohort of patients and caregivers on standard of care (SoC) alone (acetylcholinesterase inhibitors, corticosteroids, and nonsteroidal immunosuppressive therapies). Healthcare costs, tax revenue, and government benefit payments are compared to estimate incremental costs and fiscal benefits (all discounted annually at 3% over a lifetime horizon). Treatment effect is based on the ADAPT trial for efgartigimod and on an indirect treatment comparison for chronic IVIg. The link between MG-ADL scores and the workforce participation is based on MyRealWorld MG study. One-way sensitivity analysis is used to assess uncertainty.
RESULTS: Improved health outcomes are associated with increased workforce participation, reduced disability rates, and less caregiving requirements. This results in averted tax revenue losses and reduces public expenditure for the US government. Compared to SoC alone, efgartigimod is projected to cost $258,416 more per patient than IVIg. However, incremental lifetime fiscal benefits are estimated at $315,127 per patient, outweighing the drug-related costs.
CONCLUSIONS: When added to SoC, efgartigimod generates a significant fiscal return when replacing chronic IVIg, offsetting the additional drug cost--without accounting for the value of health gains to patients.
METHODS: The lifetime natural course of gMG was modelled using a Markov cohort approach, with health states defined by the MG Activities of Daily Living (MG-ADL) scores. A cohort of patients initiating treatment with chronic intravenous immunoglobulin (IVIg) or efgartigimod and their informal caregivers are compared to a cohort of patients and caregivers on standard of care (SoC) alone (acetylcholinesterase inhibitors, corticosteroids, and nonsteroidal immunosuppressive therapies). Healthcare costs, tax revenue, and government benefit payments are compared to estimate incremental costs and fiscal benefits (all discounted annually at 3% over a lifetime horizon). Treatment effect is based on the ADAPT trial for efgartigimod and on an indirect treatment comparison for chronic IVIg. The link between MG-ADL scores and the workforce participation is based on MyRealWorld MG study. One-way sensitivity analysis is used to assess uncertainty.
RESULTS: Improved health outcomes are associated with increased workforce participation, reduced disability rates, and less caregiving requirements. This results in averted tax revenue losses and reduces public expenditure for the US government. Compared to SoC alone, efgartigimod is projected to cost $258,416 more per patient than IVIg. However, incremental lifetime fiscal benefits are estimated at $315,127 per patient, outweighing the drug-related costs.
CONCLUSIONS: When added to SoC, efgartigimod generates a significant fiscal return when replacing chronic IVIg, offsetting the additional drug cost--without accounting for the value of health gains to patients.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE505
Topic
Economic Evaluation
Disease
SDC: Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)