BUDGET IMPACT OF ADDING ACORAMIDIS TO FORMULARY FOR THE TREATMENT OF TRANSTHYRETIN AMYLOID CARDIOMYOPATHY: A UNITED STATES HEALTH PLAN ANALYSIS
Author(s)
Justin Grodin, MD, MPH1, Mack Harris, BA2, Kang Kang, PhD3, Bill ONeill, MPH4, Heather Falvey, MSc4, Liana Hennum, MPT, MHA4, Omar Abou Ezzeddine, MD, MS5, Nishant R. Shah, MD, MPH6.
1UT Southwestern Medical Center, Dallas, TX, USA, 2Evidera Inc., Wilmington, NC, USA, 3Evidera Inc., Bethesda, MD, USA, 4BridgeBio Pharma, Inc., San Francisco, CA, USA, 5Mayo Clinic, Rochester, MN, USA, 6Brown University Alpert Medical School, Providence, RI, USA.
1UT Southwestern Medical Center, Dallas, TX, USA, 2Evidera Inc., Wilmington, NC, USA, 3Evidera Inc., Bethesda, MD, USA, 4BridgeBio Pharma, Inc., San Francisco, CA, USA, 5Mayo Clinic, Rochester, MN, USA, 6Brown University Alpert Medical School, Providence, RI, USA.
OBJECTIVES: To estimate the budget impact of adding acoramidis as an on-formulary treatment option for US patients with transthyretin amyloid cardiomyopathy (ATTR-CM).
METHODS: A budget impact model (BIM) estimated the effects of adding acoramidis to the formulary of a hypothetical 1,000,000-member US health plan (75% Medicare/25% commercially insured) over 3 years. Patients with ATTR-CM were estimated using published heart failure with preserved ejection fraction (HFpEF) prevalence and incidence data and the expected proportion of HFpEF attributable to ATTR-CM, with prevalent cases modeled in Year 1 and incident cases added in Years 2 and 3. The model incorporated costs of drug acquisition, cardiovascular (CV) hospitalization, adverse events, and terminal care. The BIM compared estimated costs with acoramidis off formulary (reference scenario) versus on formulary (new scenario, assumed acoramidis utilization increases of 5%/17%/27% in Years 1/2/3, respectively). Scenario analyses included matching-adjusted indirect comparison (MAIC) and combination therapy inputs.
RESULTS: Approximately 306 patients would seek treatment for ATTR-CM in Year 1, with 35 newly diagnosed patients annually thereafter. Increased acoramidis uptake in the new scenario yielded $21,952,922 (8.8%) in savings over 3 years, equivalent to reductions of $0.61 per member per month and $1,916.80 per treated member per month. Savings were driven largely by decreased drug acquisition costs and additionally by fewer CV hospitalizations. Over 3 years, 13 CV hospitalizations were avoided, yielding savings of $539,635. Results were consistent when MAIC-derived CV hospitalization inputs were used, demonstrating robustness to alternative effectiveness assumptions. A scenario where acoramidis displaced vutrisiran + tafamidis combination therapy showed increased budget savings.
CONCLUSIONS: The BIM showed adding acoramidis to formulary was associated with substantial savings over 3 years, including scenarios with MAIC and combination treatment. Savings were driven by reduced drug costs, with fewer CV hospitalizations providing additional cost offsets. This BIM analysis highlights the economic impact of improved clinical outcomes with acoramidis.
METHODS: A budget impact model (BIM) estimated the effects of adding acoramidis to the formulary of a hypothetical 1,000,000-member US health plan (75% Medicare/25% commercially insured) over 3 years. Patients with ATTR-CM were estimated using published heart failure with preserved ejection fraction (HFpEF) prevalence and incidence data and the expected proportion of HFpEF attributable to ATTR-CM, with prevalent cases modeled in Year 1 and incident cases added in Years 2 and 3. The model incorporated costs of drug acquisition, cardiovascular (CV) hospitalization, adverse events, and terminal care. The BIM compared estimated costs with acoramidis off formulary (reference scenario) versus on formulary (new scenario, assumed acoramidis utilization increases of 5%/17%/27% in Years 1/2/3, respectively). Scenario analyses included matching-adjusted indirect comparison (MAIC) and combination therapy inputs.
RESULTS: Approximately 306 patients would seek treatment for ATTR-CM in Year 1, with 35 newly diagnosed patients annually thereafter. Increased acoramidis uptake in the new scenario yielded $21,952,922 (8.8%) in savings over 3 years, equivalent to reductions of $0.61 per member per month and $1,916.80 per treated member per month. Savings were driven largely by decreased drug acquisition costs and additionally by fewer CV hospitalizations. Over 3 years, 13 CV hospitalizations were avoided, yielding savings of $539,635. Results were consistent when MAIC-derived CV hospitalization inputs were used, demonstrating robustness to alternative effectiveness assumptions. A scenario where acoramidis displaced vutrisiran + tafamidis combination therapy showed increased budget savings.
CONCLUSIONS: The BIM showed adding acoramidis to formulary was associated with substantial savings over 3 years, including scenarios with MAIC and combination treatment. Savings were driven by reduced drug costs, with fewer CV hospitalizations providing additional cost offsets. This BIM analysis highlights the economic impact of improved clinical outcomes with acoramidis.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE620
Topic
Economic Evaluation
Topic Subcategory
Budget Impact Analysis
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory)