Cost-Utility Analysis of Eculizumab for Atypical Hemolytic Uremic Syndrome (aHUS) in Thailand
Author(s)
Sutinee Soopairin, PharmD, MSc, Chanthawat Patikorn, PharmD, PhD, Parnnaphat Luksameesate, PhD, Suthira Taychakhoonavudh, PhD.
Department of Social and Administrative Pharmacy, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand.
Department of Social and Administrative Pharmacy, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand.
Presentation Documents
OBJECTIVES: This study aims to evaluate the cost-utility and budget impact of lifelong eculizumab compared with plasma therapy, a standard of care for aHUS, in Thai aHUS patients.
METHODS: A Markov model was developed to analyze the cost-utility of lifelong eculizumab treatment compared to plasma therapy in patients with aHUS from a societal perspective over a lifetime. The model included three health states: no dialysis, dialysis, and death. Input parameters were sourced from published literature and Thai-specific cost data, including direct medical costs, direct non-medical costs, and indirect costs. Health outcomes were measured in life-years (LYs) and quality-adjusted life years (QALYs). An incremental cost-effectiveness ratio (ICER) was applied to compare cost and health outcomes between lifelong eculizumab treatment and plasma therapy.
RESULTS: The results showed that the ICERs of lifelong eculizumab compared with plasma therapy were 18,544,821 Thai Baht (508,081 US Dollars) per QALY gained and 25,400,456 Thai Baht (735,851 US Dollars) per LY gained, which was not cost-effective at Thailand’s willingness-to-pay (WTP) threshold of 160,000 Thai Baht (4,384 USDollars) per QALY gained.
CONCLUSIONS: Although eculizumab has demonstrated clinical efficacy in reducing progression to ESRD and death in aHUS patients, eculizumab is not cost-effective for aHUS patients in Thailand at its current price. However, price negotiations and alternative dosing strategies may improve its economic value and support its inclusion in the National List of Essential Medicines.
METHODS: A Markov model was developed to analyze the cost-utility of lifelong eculizumab treatment compared to plasma therapy in patients with aHUS from a societal perspective over a lifetime. The model included three health states: no dialysis, dialysis, and death. Input parameters were sourced from published literature and Thai-specific cost data, including direct medical costs, direct non-medical costs, and indirect costs. Health outcomes were measured in life-years (LYs) and quality-adjusted life years (QALYs). An incremental cost-effectiveness ratio (ICER) was applied to compare cost and health outcomes between lifelong eculizumab treatment and plasma therapy.
RESULTS: The results showed that the ICERs of lifelong eculizumab compared with plasma therapy were 18,544,821 Thai Baht (508,081 US Dollars) per QALY gained and 25,400,456 Thai Baht (735,851 US Dollars) per LY gained, which was not cost-effective at Thailand’s willingness-to-pay (WTP) threshold of 160,000 Thai Baht (4,384 USDollars) per QALY gained.
CONCLUSIONS: Although eculizumab has demonstrated clinical efficacy in reducing progression to ESRD and death in aHUS patients, eculizumab is not cost-effective for aHUS patients in Thailand at its current price. However, price negotiations and alternative dosing strategies may improve its economic value and support its inclusion in the National List of Essential Medicines.
Conference/Value in Health Info
2025-09, ISPOR Real-World Evidence Summit 2025, Tokyo, Japan
Value in Health Regional, Volume 49S (September 2025)
Code
RWD285
Topic Subcategory
Health & Insurance Records Systems
Disease
SDC: Rare & Orphan Diseases