BUDGET IMPACT ANALYSIS OF OBINUTUZUMAB FOR ACTIVE LUPUS NEPHRITIS FROM THE BRAZILIAN PRIVATE HEALTHCARE SYSTEM PERSPECTIVE
Author(s)
Veronica E. Mata, MBA, MSc, PhD1, Natalia Bergamelli Ramos, BSc, MBA2, Maicon Falavigna, PhD, MD3.
1Market access & HTA Manager, F. Hoffman-La Roche, SAO PAULO, Brazil, 2Roche Pharma Brasil, Sao Paulo, Brazil, 3Inova Medical, Porto Alegre, Brazil.
1Market access & HTA Manager, F. Hoffman-La Roche, SAO PAULO, Brazil, 2Roche Pharma Brasil, Sao Paulo, Brazil, 3Inova Medical, Porto Alegre, Brazil.
OBJECTIVES: Budget impact analysis (BIA) of adding obinutuzumab for treating class III/IV lupus nephritis (with or without class V) within the Brazilian private healthcare system, using belimumab as a comparator.
METHODS: BIA with a five-year time horizon (2027-2031) comparing a current scenario (belimumab only) with an alternative scenario including obinutuzumab for the same population. The eligible population was estimated using national data. Procedure costs and frequencies came from a microcosting study. Disease progression probabilities were derived from a cost-utility model. The factory price with 18% state taxes was applied to both drugs. For belimumab, calculations considered an average patient weighing 72.4 kg and accounted for vial wastage. Infusion numbers and treatment schedules followed manufacturers' guidelines. The base case assumed a 3-year treatment duration, while a sensitivity analysis with 5-year duration, in accordance with clinical guidelines. A progressive adoption rate for obinutuzumab was assumed: 50% to 70% for prevalent cases and 30% to 50% for incident cases from year 1 to 5.
RESULTS: In the base case, 1,557 patients are eligible for treatment in the first year. The number of patients treated with obinutuzumab reached 3,645 individuals by 2031. The cumulative total cost in the obinutuzumab scenario was estimated at USD352 million, versus USD363 million in the current scenario, resulting in a five-year cumulative budget reduction of -USD11 million. In the 5-year treatment scenario, a greater cumulative budget impact was observed (-USD19,2 million).
CONCLUSIONS: Obinutuzumab represents an effective and lower-cost therapeutic alternative, driven primarily by the posological profile, the lower frequency of administrations compared to belimumab and by prolonged B-cell depletion. The budget impact analysis identifies a significant cost reduction associated with obinutuzumab. By adopting this treatment, private payers can implement a sustainable strategy for cost savings while ensuring a well-established safety profile and robust clinical efficacy in achieving complete and partial renal response.
METHODS: BIA with a five-year time horizon (2027-2031) comparing a current scenario (belimumab only) with an alternative scenario including obinutuzumab for the same population. The eligible population was estimated using national data. Procedure costs and frequencies came from a microcosting study. Disease progression probabilities were derived from a cost-utility model. The factory price with 18% state taxes was applied to both drugs. For belimumab, calculations considered an average patient weighing 72.4 kg and accounted for vial wastage. Infusion numbers and treatment schedules followed manufacturers' guidelines. The base case assumed a 3-year treatment duration, while a sensitivity analysis with 5-year duration, in accordance with clinical guidelines. A progressive adoption rate for obinutuzumab was assumed: 50% to 70% for prevalent cases and 30% to 50% for incident cases from year 1 to 5.
RESULTS: In the base case, 1,557 patients are eligible for treatment in the first year. The number of patients treated with obinutuzumab reached 3,645 individuals by 2031. The cumulative total cost in the obinutuzumab scenario was estimated at USD352 million, versus USD363 million in the current scenario, resulting in a five-year cumulative budget reduction of -USD11 million. In the 5-year treatment scenario, a greater cumulative budget impact was observed (-USD19,2 million).
CONCLUSIONS: Obinutuzumab represents an effective and lower-cost therapeutic alternative, driven primarily by the posological profile, the lower frequency of administrations compared to belimumab and by prolonged B-cell depletion. The budget impact analysis identifies a significant cost reduction associated with obinutuzumab. By adopting this treatment, private payers can implement a sustainable strategy for cost savings while ensuring a well-established safety profile and robust clinical efficacy in achieving complete and partial renal response.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE275
Topic
Economic Evaluation
Topic Subcategory
Budget Impact Analysis
Disease
Biologics & Biosimilars, Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)