Presentation (CTI)

OBJECTIVES: The study objective is to estimate the cost-effectiveness of nemolizumab + BSC (Best Supportive Care), compared to dupilumab + BSC, for the treatment of patients with moderate-to-severe prurigo nodularis from the Italian NHS perspective.
METHODS: The model has a hybrid decision-tree/Markov cohort structure. Efficacy and utility values were derived from the phase 3 studies OLYMPIA 1 and OLYMPIA 2. The LTE (Long Term Extension) trial was used to estimate long-term utility values. Comparator efficacy was derived from a SLR and NMA. The analysis took into account drug acquisition, monitoring, administration, and AEs costs. For treatments, therapy costs were calculated using ex-factory prices inclusive of mandatory discounts (-5% -5%), for nemolizumab (hypothetic price) and for dupilumab. The Base Case and sensitivity analysis considered a lifetime horizon, corresponding to 45 years; a scenario analysis was conducted with a time horizon of 10 years, as per AIFA guidelines. A discount rate of 3% for cost and benefit, as per AIFA guidelines, was applied. DSA and PSA were performed. The considered ICER threshold was € 33.000/QALY.
RESULTS: The Base Case analysis shows that nemolizumab + BSC results in an ICER of dominance when compared to dupilumab + BSC. The cost-effectiveness analysis conducted over a time horizon of 10 years, confirms the drug's value for money. Again, the ICER highlights the dominance of nemolizumab + BSC vs dupilumab + BSC. PSA analysis confirms the robustness of the results with values always close to Base Case.
CONCLUSIONS: Nemolizumab shows to be a cost-effective treatment for the Italian NHS. These results support the decision to introduce nemolizumab in routine clinical practice as a cost-effective treatment for patients with moderate-to-severe prurigo nodularis in Italy.