ADDRESSING AN UNMET THERAPEUTIC NEED IN GROUP 1 PULMONARY ARTERIAL HYPERTENSION (PAH): CLINICAL OUTCOMES AND ECONOMIC IMPLICATIONS OF PARENTERAL TREPROSTINIL IN THE MEXICAN SOCIAL SECURITY INSTITUTE (IMSS)
Author(s)
Alejandro Grimaldi Ferreira, MS1, Adán Martínez Hernández, BS2, Ariadna Giro Perafita, PhD3, Marc Valls, MS1, Victoria Castillo, MD1, Nesty Olivares Arzuaga, PhD2, Jorge Bruno Hernández García, MS2, Tania Guadalupe Chávez Elizalde, MD2.
1TIS, Mexico City, Mexico, 2Ferrer, Mexico City, Mexico, 3Ferrer, Barcelona, Spain.
1TIS, Mexico City, Mexico, 2Ferrer, Mexico City, Mexico, 3Ferrer, Barcelona, Spain.
OBJECTIVES: To assess the clinical outcomes and economic implications associated with parenteral treprostinil in patients with Group 1 PAH unable to safely or effectively receive currently available oral or inhaled PAH-specific therapies in the IMSS.
METHODS: A model-based health economic analysis was conducted to estimate survival, disease progression, quality-adjusted life years (QALYs), direct medical and indirect costs associated with parenteral treprostinil treatment in Group 1 PAH patients. Clinical inputs were derived from Kaplan-Meier data reported by Hiremath et al. (2010), digitized and extrapolated using parametric survival regressions. Health-related quality of life was estimated by linking worsening states to PAH functional classes using utility weights derived from European and Mexican published EQ-5D evidence (Nafees et al., 2023; Greiner et al., 2011; Gutierrez-Delgado et al., 2011). Costs included pharmacological treatment, healthcare resource utilization, adverse events, and productivity losses, from the perspective of IMSS.
RESULTS: Parenteral treprostinil treatment was associated with clinically meaningful survival outcomes, delayed disease progression, and improved QALYs. According to the partitioned survival model, treprostinil achieved one-year survival exceeding 66% of patients, compared to fewer than 17% without treprostinil. The model estimated cumulative effectiveness of 0.823 life-years and 0.650 QALYs over a one-year time horizon. Treprostinil was associated with a relative risk (RR) of 3.95 of survival and 2.13 for worsening-free survival compared to patients without treprostinil. The average annual total cost was $2,024,542.51 MXN, principally driven by the treatment costs ($1,675,880.49 MXN), approximately 79.8% of total costs.
CONCLUSIONS: Parenteral treprostinil may address an important unmet therapeutic need for a clinically identifiable subgroup of Group 1 PAH patients within the IMSS who cannot receive currently available oral or inhaled therapies. Given its potential to provide disease-specific treatment in a population currently lacking institutionally administrable therapeutic alternatives, treprostinil represents a potentially valuable option for reducing inequities in access to specialized PAH treatment in Mexico.
METHODS: A model-based health economic analysis was conducted to estimate survival, disease progression, quality-adjusted life years (QALYs), direct medical and indirect costs associated with parenteral treprostinil treatment in Group 1 PAH patients. Clinical inputs were derived from Kaplan-Meier data reported by Hiremath et al. (2010), digitized and extrapolated using parametric survival regressions. Health-related quality of life was estimated by linking worsening states to PAH functional classes using utility weights derived from European and Mexican published EQ-5D evidence (Nafees et al., 2023; Greiner et al., 2011; Gutierrez-Delgado et al., 2011). Costs included pharmacological treatment, healthcare resource utilization, adverse events, and productivity losses, from the perspective of IMSS.
RESULTS: Parenteral treprostinil treatment was associated with clinically meaningful survival outcomes, delayed disease progression, and improved QALYs. According to the partitioned survival model, treprostinil achieved one-year survival exceeding 66% of patients, compared to fewer than 17% without treprostinil. The model estimated cumulative effectiveness of 0.823 life-years and 0.650 QALYs over a one-year time horizon. Treprostinil was associated with a relative risk (RR) of 3.95 of survival and 2.13 for worsening-free survival compared to patients without treprostinil. The average annual total cost was $2,024,542.51 MXN, principally driven by the treatment costs ($1,675,880.49 MXN), approximately 79.8% of total costs.
CONCLUSIONS: Parenteral treprostinil may address an important unmet therapeutic need for a clinically identifiable subgroup of Group 1 PAH patients within the IMSS who cannot receive currently available oral or inhaled therapies. Given its potential to provide disease-specific treatment in a population currently lacking institutionally administrable therapeutic alternatives, treprostinil represents a potentially valuable option for reducing inequities in access to specialized PAH treatment in Mexico.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
HTA163
Topic
Clinical Outcomes, Economic Evaluation, Health Technology Assessment
Topic Subcategory
Value Frameworks & Dossier Format
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory), Rare & Orphan Diseases, Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)