ECONOMIC EVALUATION OF SPARSENTAN VERSUS TARGETED-RELEASE FORMULATION BUDESONIDE IN PATIENTS WITH PRIMARY IMMUNOGLOBULIN A NEPHROPATHY IN AUSTRIA
Author(s)
Martin Koch, MBA1, Antonio Ramirez de Arellano Serna, MSc, DPhil2, Clarissa Sancho, MSc3, Noemi Lopez, MSc3, Tom Edmonds, MSc4.
1CSL, Vienna, Austria, 2CSL, Zürich, Switzerland, 3Cencora PharmaLex, Barcelona, Spain, 4Initiate Consultancy, Nottingham, United Kingdom.
1CSL, Vienna, Austria, 2CSL, Zürich, Switzerland, 3Cencora PharmaLex, Barcelona, Spain, 4Initiate Consultancy, Nottingham, United Kingdom.
OBJECTIVES: To assess the efficiency of sparsentan versus targeted-release formulation budesonide (TRF-budesonide) plus standard of care (SoC) in adult patients with primary immunoglobulin A nephropathy (IgAN) and urine protein excretion (UPE) ≥1.0 g/day (or urine protein-to-creatinine ratio [UPCR] ≥0.75 g/g) in Austria.
METHODS: A cohort-level Markov state-transition model was adapted to the Austrian setting to reflect the lifelong and progressive nature of IgAN. The model utilises fifteen health states (excluding death): three chronic kidney disease (CKD) states (CKD1/2, CKD3 and CKD4) for each of the four UPE levels (<0.5, 0.5-1.0, 1.0-2.0, >2.0 g/day) with an additional three health states within end-stage renal disease (ESRD) (pre-renal replacement therapy, dialysis and transplant). Comparative efficacy of the change from baseline UPE with the treatment of sparsentan versus TRF-budesonide+SoC was informed by a matched-adjusted indirect comparison analysis using individual patient data from PROTECT and published aggregate data from the NefIgArd trials. Direct medical costs were included (drug acquisition, disease management and ESRD care) expressed in 2025 euros. Health outcomes were measured in quality-adjusted life years (QALYs). A discount rate of 3% was applied to costs and health outcomes. A lifetime time horizon (55 years) was considered. Sensitivity analyses evaluated model robustness.
RESULTS: Sparsentan resulted in 1.48 QALYs gained versus TRF-budesonide+SoC increasing the time spent in earlier CKD stages (CKD1-CKD4), with a gain of 2.59 QALYs, and reduced time spent in ESRD of −1.11 QALYs. These clinical benefits translated into improved long-term outcomes and reduced ESRD-related management costs. In the base-case analysis, sparsentan was considered cost-effective at a willingness-to-pay threshold of €60,000/QALYs. Sensitivity analyses confirmed the robustness of the results.
CONCLUSIONS: As a rare disease that may lead to ESRD, IgAN imposes a substantial burden. Sparsentan represents a cost‑effective option in Austria improving health outcomes and reducing costs by slowing down CKD progression.
METHODS: A cohort-level Markov state-transition model was adapted to the Austrian setting to reflect the lifelong and progressive nature of IgAN. The model utilises fifteen health states (excluding death): three chronic kidney disease (CKD) states (CKD1/2, CKD3 and CKD4) for each of the four UPE levels (<0.5, 0.5-1.0, 1.0-2.0, >2.0 g/day) with an additional three health states within end-stage renal disease (ESRD) (pre-renal replacement therapy, dialysis and transplant). Comparative efficacy of the change from baseline UPE with the treatment of sparsentan versus TRF-budesonide+SoC was informed by a matched-adjusted indirect comparison analysis using individual patient data from PROTECT and published aggregate data from the NefIgArd trials. Direct medical costs were included (drug acquisition, disease management and ESRD care) expressed in 2025 euros. Health outcomes were measured in quality-adjusted life years (QALYs). A discount rate of 3% was applied to costs and health outcomes. A lifetime time horizon (55 years) was considered. Sensitivity analyses evaluated model robustness.
RESULTS: Sparsentan resulted in 1.48 QALYs gained versus TRF-budesonide+SoC increasing the time spent in earlier CKD stages (CKD1-CKD4), with a gain of 2.59 QALYs, and reduced time spent in ESRD of −1.11 QALYs. These clinical benefits translated into improved long-term outcomes and reduced ESRD-related management costs. In the base-case analysis, sparsentan was considered cost-effective at a willingness-to-pay threshold of €60,000/QALYs. Sensitivity analyses confirmed the robustness of the results.
CONCLUSIONS: As a rare disease that may lead to ESRD, IgAN imposes a substantial burden. Sparsentan represents a cost‑effective option in Austria improving health outcomes and reducing costs by slowing down CKD progression.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE245
Topic
Economic Evaluation
Disease
Rare & Orphan Diseases, Urinary/Kidney Disorders