Cost-Effectiveness of Rozanolixizumab vs. Efgartigimod in the Treatment of Generalized Myasthenia Gravis (gMG) in Greece
Author(s)
CHRISTINA GOLNA, LLM, MSc1, Pavlos Golnas, MSc1, Michael Feretos, MSc2, Sergei Kalynych, PhD3, Ramona SCHMID, MSc, PharmD4, Hicham Benhaddi, MSc4, Vasilios K. Kimiskidis, MD, PhD5, Kyriakos Souliotis, PhD6.
1Health Policy Institute, Maroussi, Greece, 2UCB, Athens, Greece, 3UCB, Prague, Czech Republic, 4UCB, Colombes, France, 5Department of Neurology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece, 6School of Social and Political Sciences, University of Peloponnese, Corinth, Greece.
1Health Policy Institute, Maroussi, Greece, 2UCB, Athens, Greece, 3UCB, Prague, Czech Republic, 4UCB, Colombes, France, 5Department of Neurology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece, 6School of Social and Political Sciences, University of Peloponnese, Corinth, Greece.
OBJECTIVES: To evaluate the cost-effectiveness of rozanolixizumab compared to efgartigimod in adult patients with generalized myasthenia gravis (gMG), including anti-acetylcholine receptor (AChR+) and anti-muscle-specific kinase (MuSK+) antibody-positive subpopulations, from the perspective of the third-party payer in Greece.
METHODS: A global Markov model with a lifetime horizon (48.4 years) was localized to the Greek healthcare setting. The model compared rozanolixizumab + standard of care (SoC) vs. efgartigimod + SoC. Treatment efficacy and quality of life data were sourced from clinical trials and a network meta-analysis. Costs included drug acquisition, administration, monitoring, disease management, and adverse events, at 2024 Euros. The cost per model cycle for both comparators was calculated based on drug cost per administration, administrations per treatment cycle (rozanolixizumab 5.24, efgartigimod 4.0), and time on and off treatment per cycle (rozanolixizumab 7.65 weeks, efgartigimod 4.0 weeks, for both). Mean patient weight was 81.93 kg. Rozanolixizumab was administered for 3.4 cycles per year and efgartigimod for 6.5. Vial sharing was not permitted, as is standard clinical practice in Greece. All patients were assumed to discontinue treatment after 2 years. Health benefits were measured in quality-adjusted life years (QALYs). An annual discount rate of 3.5% was applied to both costs and QALYs. Incremental cost-effectiveness ratios (ICERs) were calculated. Sensitivity analyses explored parameter uncertainty.
RESULTS: Over a lifetime horizon, rozanolixizumab + SoC resulted in an additional 0.063 QALYs and an incremental saving of €220,426.49 versus efgartigimod. Due to small differences in health outcomes between comparators, differences in treatment-related costs appeared to be the main driver of cost-effectiveness. Results of both probabilistic and deterministic sensitivity analyses confirmed the robustness of model outcomes.
CONCLUSIONS: Rozanolixizumab + SoC offers more QALYs at an incremental saving over a lifetime horizon for the third-party payer in Greece compared to efgartigimod + SoC in gMG patients who remain symptomatic on SoC alone.
METHODS: A global Markov model with a lifetime horizon (48.4 years) was localized to the Greek healthcare setting. The model compared rozanolixizumab + standard of care (SoC) vs. efgartigimod + SoC. Treatment efficacy and quality of life data were sourced from clinical trials and a network meta-analysis. Costs included drug acquisition, administration, monitoring, disease management, and adverse events, at 2024 Euros. The cost per model cycle for both comparators was calculated based on drug cost per administration, administrations per treatment cycle (rozanolixizumab 5.24, efgartigimod 4.0), and time on and off treatment per cycle (rozanolixizumab 7.65 weeks, efgartigimod 4.0 weeks, for both). Mean patient weight was 81.93 kg. Rozanolixizumab was administered for 3.4 cycles per year and efgartigimod for 6.5. Vial sharing was not permitted, as is standard clinical practice in Greece. All patients were assumed to discontinue treatment after 2 years. Health benefits were measured in quality-adjusted life years (QALYs). An annual discount rate of 3.5% was applied to both costs and QALYs. Incremental cost-effectiveness ratios (ICERs) were calculated. Sensitivity analyses explored parameter uncertainty.
RESULTS: Over a lifetime horizon, rozanolixizumab + SoC resulted in an additional 0.063 QALYs and an incremental saving of €220,426.49 versus efgartigimod. Due to small differences in health outcomes between comparators, differences in treatment-related costs appeared to be the main driver of cost-effectiveness. Results of both probabilistic and deterministic sensitivity analyses confirmed the robustness of model outcomes.
CONCLUSIONS: Rozanolixizumab + SoC offers more QALYs at an incremental saving over a lifetime horizon for the third-party payer in Greece compared to efgartigimod + SoC in gMG patients who remain symptomatic on SoC alone.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE273
Topic
Clinical Outcomes, Economic Evaluation, Health Technology Assessment
Disease
Neurological Disorders