COST-EFFECTIVENESS OF OBINUTUZUMAB FOR THE TREATMENT OF ACTIVE LUPUS NEPHRITIS IN COLOMBIA: FROM HEALTHCARE SYSTEM AND SOCIETAL PERSPECTIVES
Author(s)
Jorge Pérez-Velásquez, MD1, Gustavo Jose Aroca, Sr., MD1, Sergio A. Cáceres-Maldonado, MD, MSc2, Claudia Hernández-Castillo, MD, MSc2, Melissa Diaz Puentes, MSc, MD2, Mauricio Hernandez, MD2, Laura Catalina Prieto, MD, MSc2.
1Clínica de la Costa, Barranquilla, Colombia, 2Roche, Bogotá, Colombia.
1Clínica de la Costa, Barranquilla, Colombia, 2Roche, Bogotá, Colombia.
OBJECTIVES: Lupus nephritis (LN) causes progressive kidney damage, high healthcare resource use (HCRU), and substantial long-term costs. Obinutuzumab plus standard-of-care (SoC) improves renal response. This study aimed to estimate the cost-effectiveness of obinutuzumab plus SoC versus SoC alone for active LN in Colombia.
METHODS: A cost-effectiveness analysis was conducted in Colombia from a societal perspective, using a lifetime horizon and a 5% annual discount rate. Health states captured renal response (complete-CRR and partial-PRR), disease progression, and death. Clinical inputs were derived from the REGENCY trial. Data on work productivity losses, for the social component (absenteeism and presenteeism), and utilities were obtained from literature. HCRU and indirect costs were validated by local experts. Direct medical costs, including those for renal flares, as well as the average salary, were obtained from public sources. Uncertainty was evaluated using deterministic and probabilistic sensitivity analysis (PSA) under a willingness-to-pay threshold for Colombia of 86% of 1GDP=USD 7,416 per QALY gained (1USD=4,052.72COP).
RESULTS: Compared with SoC, obinutuzumab was associated with 0.66 additional QALYs per patient over the model time horizon. Total costs were USD121,667 for obinutuzumab and USD120,432 for SoC, resulting in an incremental cost of USD1,235, driven by cost offsets in supportive care (USD7,500), end-of-life care (USD462), and productivity losses (USD926). The incremental cost-effectiveness ratio (ICER) was 1,877/QALY, including indirect costs, and USD2,911/QALY without these costs. The main driver of the ICER in the univariate analysis was the probability of achieving CRR and PRR where Obinutuzumab demonstrated a greater chance of achieving CRR (54%) and PRR (38%). In the PSA, obinutuzumab had a 58% probability of being cost-effective.
CONCLUSIONS: Obinutuzumab represents a cost-effective treatment option from different perspectives for Colombia compared with SoC, given its long-term prevention of advanced kidney disease. When considering productivity losses, obinutuzumab improves health outcomes, quality of life, reduces social burden, and renal complication costs.
METHODS: A cost-effectiveness analysis was conducted in Colombia from a societal perspective, using a lifetime horizon and a 5% annual discount rate. Health states captured renal response (complete-CRR and partial-PRR), disease progression, and death. Clinical inputs were derived from the REGENCY trial. Data on work productivity losses, for the social component (absenteeism and presenteeism), and utilities were obtained from literature. HCRU and indirect costs were validated by local experts. Direct medical costs, including those for renal flares, as well as the average salary, were obtained from public sources. Uncertainty was evaluated using deterministic and probabilistic sensitivity analysis (PSA) under a willingness-to-pay threshold for Colombia of 86% of 1GDP=USD 7,416 per QALY gained (1USD=4,052.72COP).
RESULTS: Compared with SoC, obinutuzumab was associated with 0.66 additional QALYs per patient over the model time horizon. Total costs were USD121,667 for obinutuzumab and USD120,432 for SoC, resulting in an incremental cost of USD1,235, driven by cost offsets in supportive care (USD7,500), end-of-life care (USD462), and productivity losses (USD926). The incremental cost-effectiveness ratio (ICER) was 1,877/QALY, including indirect costs, and USD2,911/QALY without these costs. The main driver of the ICER in the univariate analysis was the probability of achieving CRR and PRR where Obinutuzumab demonstrated a greater chance of achieving CRR (54%) and PRR (38%). In the PSA, obinutuzumab had a 58% probability of being cost-effective.
CONCLUSIONS: Obinutuzumab represents a cost-effective treatment option from different perspectives for Colombia compared with SoC, given its long-term prevention of advanced kidney disease. When considering productivity losses, obinutuzumab improves health outcomes, quality of life, reduces social burden, and renal complication costs.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE739
Topic
Economic Evaluation
Topic Subcategory
Work & Home Productivity - Indirect Costs
Disease
Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain), Urinary/Kidney Disorders