Presentation (CTI)

OBJECTIVES: To evaluate the cost-effectiveness of obinutuzumab beta (obinutuzumab beta) relative to obinutuzumab for primary membranous nephropathy (pMN) in China from the healthcare perspective. By integrating MAIC-derived efficacy into cost utility markov model, we provide, to our knowledge, the first pMN cost-effectiveness analysis using formal indirect comparison.
METHODS: A monthly-cycle Markov state-transition model adapted from a published pMN health economic model simulated a cohort of patients starting at age 51 years over a 28-year lifetime horizon (336 cycles), with half-cycle correction and 5% annual discounting. Because no head-to-head randomised trial compared the two agents, an anchored matching-adjusted indirect comparison (MAIC) reweighted obinutuzumab beta phase III individual patient data to the MAJESTY obinutuzumab population, comparing complete remission (CR) and partial remission (PR) rates at weeks 52, 76, and 104. The model was implemented in R using a multi-state Markov framework. Cost-effectiveness was assessed against CNY 298,995 per QALY (three times China's 2025 per capita gross domestic product of CNY 99,665).
RESULTS: From the healthcare perspective, discounted lifetime costs were CNY 297,712 for obinutuzumab beta and CNY 334,586 for obinutuzumab; discounted quality-adjusted life years (QALYs) were 8.97 and 7.84, respectively. Obinutuzumab beta was dominant (lower cost and greater QALYs), saving CNY 36,874 and gaining 1.13 QALYs. One-way and probabilistic sensitivity analyses supported the dominance conclusion.
CONCLUSIONS: In Chinese pMN patients, lifetime Markov modelling demonstrates that obinutuzumab beta is a dominant strategy relative to obinutuzumab from the healthcare perspective, offering lower lifetime costs and additional health gains.