Economic Evaluation of Bispecific Antibodies in Europe: A Systematic Review
Author(s)
Debjit Ghoshal, M Pharm, Prakhar Lambhate, M Pharm, Sumi Pillai, Pharm D, Tanya Madan, M Pharm.
Lumanity, Gurugram, India.
Lumanity, Gurugram, India.
OBJECTIVES: Bispecific antibodies are engineered molecules that can bind to two different types of antigens or epitopes. This systematic literature review (SLR) assessed model-based economic evaluations of bispecific antibodies in Europe.
METHODS: A systematic search of Embase® and PubMed® was conducted up to June 2025 to identify English-language publications on the economic evaluation of bispecific antibodies in various diseases. Searches were conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Two independent reviewers screened publications, with a third resolving discrepancies.
RESULTS: Of the 1,683 studies identified, four met the inclusion criteria and five were added from bibliography, totalling nine studies. Two cost-utility analyses each were conducted in France, the Netherlands, and the UK, and one each in Spain and Italy. A cost-minimization analysis covered the broader Europe (UK and EU4 countries). In France, emicizumab and blinatumomab were found to be dominant and cost-effective treatments for patients with haemophilia A with inhibitors and patients with high-risk first-relapse B-cell precursor acute lymphoblastic leukaemia, respectively, compared with relevant alternatives. Elranatamab was cost-effective compared with physician’s choice of treatment (incremental cost-effectiveness ratio: €24,754/quality-adjusted life year [QALY]) for relapsed/refractory multiple myeloma in Spain, outperforming teclistamab, providing 0.60 additional QALYs and saving €101,026. In the UK, faricimab dominated over aflibercept, with total cost savings of £15,108,609 and 60.06 QALYs gained for patients with wet age-related macular degeneration or diabetic macular oedema. The cost-minimization analysis across Europe showed that using recombinant factor VIII Fc instead of emicizumab resulted in 5-year savings of €89.3-150 million for adolescents/adults and €173.4-253.2 million for children with haemophilia A without inhibitors.
CONCLUSIONS: Our review showed that most bispecific antibodies were either highly effective or cost-efficient. Implementing these treatments can lead to improved health outcomes and significant economic advantages in managing a range of disease conditions.
METHODS: A systematic search of Embase® and PubMed® was conducted up to June 2025 to identify English-language publications on the economic evaluation of bispecific antibodies in various diseases. Searches were conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Two independent reviewers screened publications, with a third resolving discrepancies.
RESULTS: Of the 1,683 studies identified, four met the inclusion criteria and five were added from bibliography, totalling nine studies. Two cost-utility analyses each were conducted in France, the Netherlands, and the UK, and one each in Spain and Italy. A cost-minimization analysis covered the broader Europe (UK and EU4 countries). In France, emicizumab and blinatumomab were found to be dominant and cost-effective treatments for patients with haemophilia A with inhibitors and patients with high-risk first-relapse B-cell precursor acute lymphoblastic leukaemia, respectively, compared with relevant alternatives. Elranatamab was cost-effective compared with physician’s choice of treatment (incremental cost-effectiveness ratio: €24,754/quality-adjusted life year [QALY]) for relapsed/refractory multiple myeloma in Spain, outperforming teclistamab, providing 0.60 additional QALYs and saving €101,026. In the UK, faricimab dominated over aflibercept, with total cost savings of £15,108,609 and 60.06 QALYs gained for patients with wet age-related macular degeneration or diabetic macular oedema. The cost-minimization analysis across Europe showed that using recombinant factor VIII Fc instead of emicizumab resulted in 5-year savings of €89.3-150 million for adolescents/adults and €173.4-253.2 million for children with haemophilia A without inhibitors.
CONCLUSIONS: Our review showed that most bispecific antibodies were either highly effective or cost-efficient. Implementing these treatments can lead to improved health outcomes and significant economic advantages in managing a range of disease conditions.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE375
Topic
Economic Evaluation, Study Approaches
Disease
Personalized & Precision Medicine