Cost-Minimization Analysis and Economic Impact in EGPA: Evidence From MANDARA
Author(s)
Carlos Almonacid, MD1, Susana Romero, MD2, Joaquín Borrás, MD3, Nuria Rudi, MD4, Jorge Mestre-Ferrandiz, BA, MSc, PhD5, Ivan Vidal, MSc6, Néstor Martínez Martínez, MSc6, Carla Garí-Peris, MSc7.
1Pulmonology Department, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain, 2Rheumatology Department, Complexo Hospitalario Universitario de Pontevedra, Pontevedra, Spain, 3Pharmacy Department, Hospital de Sagunto, Puerto de Sagunto, Spain, 4Pharmacy Department, Granollers General Hospital, Granollers, Spain, 5Department of Economics, Universidad Carlos III, Madrid, Spain, 6AstraZeneca, Madrid, Spain, 7Outcomes’10 (a ProductLife Group Company), Castellón, Spain.
1Pulmonology Department, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain, 2Rheumatology Department, Complexo Hospitalario Universitario de Pontevedra, Pontevedra, Spain, 3Pharmacy Department, Hospital de Sagunto, Puerto de Sagunto, Spain, 4Pharmacy Department, Granollers General Hospital, Granollers, Spain, 5Department of Economics, Universidad Carlos III, Madrid, Spain, 6AstraZeneca, Madrid, Spain, 7Outcomes’10 (a ProductLife Group Company), Castellón, Spain.
OBJECTIVES: Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare vasculitis characterized by asthma, eosinophilia, and multi-organ involvement, leading to relapses and increased costs. Benralizumab, approved for severe eosinophilic asthma and recently for EGPA, has a key anti-eosinophil mechanism that depletes eosinophils via antibody-dependent cellular cytoxicity. In the MANDARA trial, benralizumab demonstrated comparable efficacy and safety versus mepolizumab, with enhanced convenience and oral corticosteroid (OCS) withdrawal. This study aims to perform a cost-minimization analysis comparing the annual acquisition costs of benralizumab versus mepolizumab in eligible EGPA patients from the Spanish National Health System perspective.
METHODS: A one-year cost-minimization model was developed using drug acquisition costs based on 2025 ex-factory prices. Mepolizumab is administered once every 4 weeks, requiring three injections per visit (39 units per year), while benralizumab requires one injection per visit every 4 weeks (13 units per year). Annual acquisition costs were calculated based on Spanish costs databases and sensitivity analyses (SA) were included.
RESULTS: Annual treatment costs were €26,118 for benralizumab and €39,177 for mepolizumab, yielding a consistent saving of €13,059 per patient—33 % less than mepolizumab. These findings were robust and consistent in the SA. In a cohort of 473 eligible EGPA patients, this translates to annual savings of €6.18 million.
CONCLUSIONS: In patients with EGPA, benralizumab is an efficient treatment with lower annual costs than mepolizumab, supporting its role as a more sustainable alternative.
METHODS: A one-year cost-minimization model was developed using drug acquisition costs based on 2025 ex-factory prices. Mepolizumab is administered once every 4 weeks, requiring three injections per visit (39 units per year), while benralizumab requires one injection per visit every 4 weeks (13 units per year). Annual acquisition costs were calculated based on Spanish costs databases and sensitivity analyses (SA) were included.
RESULTS: Annual treatment costs were €26,118 for benralizumab and €39,177 for mepolizumab, yielding a consistent saving of €13,059 per patient—33 % less than mepolizumab. These findings were robust and consistent in the SA. In a cohort of 473 eligible EGPA patients, this translates to annual savings of €6.18 million.
CONCLUSIONS: In patients with EGPA, benralizumab is an efficient treatment with lower annual costs than mepolizumab, supporting its role as a more sustainable alternative.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE282
Topic
Economic Evaluation
Disease
Rare & Orphan Diseases, Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)