OBJECTIVES: In China, intravenous belimumab is listed for the treatment of SLE¹; however, no evaluation of its cost-effectiveness exists. We estimated the cost-effectiveness of belimumab plus standard therapy (ST) versus ST alone, among patients with SLE, from the government payer perspective in China.

METHODS: This study (GSK Study 213264) utilised a modified lifetime microsimulation cost-effectiveness model²; the target population was adults with active, autoantibody-positive SLE in China. Belimumab + ST-treated patients were compared with ST-treated patients. Short-term efficacy data were implemented from a belimumab trial in North East Asia (BLISS-NEA). Long-term outcomes were modelled using longitudinal statistical models from the Hopkins Lupus Registry, calibrated using long-term organ damage outputs based on observed outcomes of belimumab-treated patients.³ China-specific costs, epidemiology data, and locally adjusted utilities were based on a targeted literature review and a key opinion leader survey. Outcomes (discounted at 5%) were incremental cost-utility ratio (ICUR), incremental cost-effectiveness ratio (ICER), life-years gained, and quality-adjusted life-years (QALYs) gained over a lifetime horizon.

RESULTS: Belimumab + ST-treated patients gained 14.92 life-years and 9.06 QALYs, versus 14.54 and 8.48, respectively, for ST-treated patients. Benefit associated with belimumab was driven by decreased organ damage and associated mortality risk. The ICUR was $6437 (2019 US dollars) per QALY gained; the ICER was $10,043 per life-year gained.

CONCLUSIONS: The ICUR was within three times China’s 2019 gross domestic product ($30,651), previously used by the World Health Organisation as a cost-effectiveness threshold⁴ and frequently used in cost-effectiveness studies in China. These findings suggest that belimumab + ST would be more cost-effective than ST alone for the treatment of SLE in China.

REFERENCES:

¹GSK. Press Release. 2022. https://www.gsk.com/en-gb/media/press-releases/china-s-national-medical-products-administration-approves-benlysta-belimumab-for-adult-patients-with-active-lupus-nephritis/#:~:text=GlaxoSmithKline%20plc%20(LSE%2FNYSE%3A,are%20receiving%20standard%20of%20care. [Accessed June 2022].

²NICE. Belimumab Technology Appraisal Guidance. 2021. https://www.nice.org.uk/guidance/ta752/resources/belimumab-for-treating-active-autoantibodypositive-systemic-lupus-erythematosus-pdf-82611372078277#page=14&zoom=100,0,670 [Accessed June 2022].

³Asukai Y, et al. Value Health Reg Issues. 2020;22:S65.

⁴Woods B, et al. Value Health. 2016;19:929–35.

FUNDING: GSK