Value Contribution of Olipudase Alfa Therapy for the Treatment of Non-Central Nervous System Manifestations of Acid Sphingomyelinase Deficiency (ASMD) By Multi-Criteria Decision Analysis (MCDA)
Author(s)
Abad MR1, González-Meneses A2, Gras E3, Poveda JL4, Trillo JL5, de Vicente D6, Villarubia J7, Baret M8, Badia FJ8
1Hospital Miguel Servet, Zaragoza, Spain, 2Hospital Universitario Virgen del Rocío, Seville, Spain, 3Hospital de Manises, Valencia, Spain, 4Hospital Universitari i Politècnic La Fe, Valencia, Spain, 5Departament Clínic Malvarrosa, Valencia, Spain, 6ASMD España, Madrid, Spain, 7Hospital Universitario Ramon y Cajal, Madrid, Spain, 8Omakase Consulting S.L., Barcelona, Spain
Presentation Documents
OBJECTIVES: To determine the value of olipudase alfa compared with placebo in the treatment of non-central nervous system (CNS) manifestations of Acid Sphingomyelinase Deficiency (ASMD) using MCDA.
METHODS: EVIDEM (v 4.0) MCDA Framework adapted to the context of orphan drugs and rare diseases was selected and adjusted for this study. A targeted literature review was conducted to populate the framework, comprised of 9 quantitative and 3 contextual criteria. The weighting used was performed by 98 evaluators and decision makers. The value contribution was obtained from the scoring of the criteria by a multidisciplinary panel including 5 hospital pharmacists and 2 clinicians with experience in ASMD, and a patient representative (n=8).
RESULTS: ASMD was considered a severe disease (mean±SD: 4.1±-0.6), with significant unmet needs given that current treatment is purely symptomatic (4.9±0.4). Experts perceived that olipudase alfa might provide a substantial improvement in efficacy/effectiveness (4.4±0.7) and has a favourable safety profile (3.0±2.6), whereas reduced differences were found in patient-reported outcomes (PROs) (2.4±1.8). Additionally, the therapeutic benefit generated by olipudase alfa was considered high (4.3±0.7). Experts anticipated an average of lower medical costs (2.6±1.3) and indirect cost savings (2.9±1.1). Evidence presented for olipudase alfa was considered high in the context of orphan drugs (3.9±1.0). In contextual criteria, most experts perceived a positive impact on population priorities and access (88%), common goal and specific interests (88%), and system capacity and appropriate use (100%). The result of the value contribution of olipudase alfa was 0.73 (in a -1 to +1 scale).
CONCLUSIONS: ASMD is a rare disease with significant unmet needs and a high impact on morbidity, mortality, and quality of life. Olipudase alfa provides very high added value to the treatment of non-CNS manifestations of ASMD using MCDA, showing a significant improvement in all severity parameters studied and potentially modifying its clinical course.
Conference/Value in Health Info
Value in Health, Volume 25, Issue 12S (December 2022)
Code
HTA130
Topic
Health Technology Assessment
Topic Subcategory
Decision & Deliberative Processes
Disease
SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity), SDC: Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)