NINTEDANIB COST-UTILITY IN IDIOPATHIC PULMONARY FIBROSIS IN FRANCE
Author(s)
Bénard S1, Schmidt A1, Catella L1, Porte F1, Setton M2, Fernandez-Montoya C2, Le Lay K2
1st[è]ve consultants, Oullins, France, 2Boehringer Ingelheim France, Paris, France
OBJECTIVES: Idiopathic pulmonary fibrosis (IPF) is a specific form of chronic, progressive, fibrosing interstitial pneumonia of unknown cause. To date, there is no cure for IPF and only two treatments (pirfenidone and recently nintedanib) have marketing authorizations and recommendations in current international guidelines. A cost-utility analysis (CUA) has been realized to evaluate the efficiency of nintedanib, a new specific IPF treatment, in comparison to all currently available alternatives, in a French setting using the current official methodological guidelines. METHODS: A previously developed, lifetime Markov Model was adapted to the French setting by simulating the progression of IPF patients in terms of lung function decline, incidence of acute exacerbations and death. Considering the effect of IPF on patients’ quality of life, a CUA integrating quality adjusted life years (QALYs) was chosen as the primary outcome measure in the main analysis. Costs and effects were discounted at 4% per year. One-way, probabilistic and scenario sensitivity analyses were performed to evaluate the robustness of the model. RESULTS: Treatment with nintedanib resulted in an estimated total cost of €76,668 (versus €82,667 for pirfenidone). In comparison with all other currently available options, nintedanib was predicted to provide the most QALYs gained. This analysis predicts that nintedanib is cost-effective, with a 57.1% chance of being more effective than pirfenidone, and a 76.2% chance of being cheaper than pirfenidone. Moreover, nintedanib remained the most efficient strategy versus pirfenidone regardless of the willingness-to-pay threshold considered. Sensitivity analyses showed that the results of the CUA to be robust. CONCLUSIONS: Nintedanib was less costly and generated more QALYs than pirfenidone, due to fewer acute exacerbations and a better tolerability profile. These results are in line with others assessments realized in Scotland by the Scottish Medicines Consortium and in UK by the National Institute for Health and Care Excellence.
Conference/Value in Health Info
2016-10, ISPOR Europe 2016, Vienna, Austria
Value in Health, Vol. 19, No. 7 (November 2016)
Code
PRS45
Topic
Economic Evaluation
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
Rare and Orphan Diseases, Respiratory-Related Disorders