OBJECTIVES:

To evaluate clinical and economic outcomes associated with valbenazine compared with deutetrabenazine in patients with Huntington Chorea.

METHODS:

We developed a Markov model simulating a three year time horizon with weekly cycles using clinical data from each phase III clinical trial of valbenazine and deutetrabenazine. Transition probabilities between four health states defined by patient’s Huntington Chorea severity were derived from the trials. Clinical outcomes included quality-adjusted life years (QALYs) and life-years. Time trade-off was used for utility inputs and wholesale acquisition cost was used for medication costs. Non-medication-related healthcare costs were assumed to be equivalent. Costs and outcomes were discounted at 3% per year and half-cycle correction was calculated. Fourteen unique parameters with low and high inputs were used for an one-way sensitivity analysis.

RESULTS:

Patients managed with valbenazine compared to those managed with deutetrabenazine were projected to gain more QALYs (0.95 vs. 0.94) at lower healthcare costs ($305,979 vs. $497,301) over 3 years. Both groups gained 2.74 life-years. With lower costs and higher QALYs, valbenazine was the dominant treatment strategy. One-way sensitivity analysis suggests the biggest change in incremental QALYs is observed with low input for the transition probability between mild and moderate/severe health states for patients taking valbenazine (+0.44 incremental QALYs). The biggest change in incremental costs is observed with high input for the annual cost of deutetrabenazine (+$87,165 incremental costs).

CONCLUSIONS:

Valbenazine is an economically dominant treatment for patients with Huntington Chorea.