BUDGETARY IMPACT TO A U.S. HEALTH PLAN OF ADOPTING SIMEPREVIR (SMV) IN COMBINATION WITH PEGINTERFERON ALFA+RIBAVIRIN (PR) FOR THE TREATMENT OF GENOTYPE 1 (G1) CHRONIC HEPATITIS C (CHC) INFECTION
Author(s)
Forlenza JB1, van de Wetering G2, Treur M2, Cerri K3, LaMori J4, Tandon N1
1Janssen Scientific Affairs, LLC, Titusville, NJ, USA, 2Pharmerit International, Rotterdam, The Netherlands, 3Janssen Pharmaceutica NV, Beerse, Belgium, 4Janssen Scientific Affairs, LLC, Raritan, NJ, USA
OBJECTIVES: Economic evaluations of CHC therapies may be important from health plans’ perspectives. METHODS: A budget impact model compared annual CHC therapy cost before and after SMV+PR adoption for a hypothetical 1,000,000 member plan. The proportion treated for CHC was derived from various publications. Base case analyses assumed Current state market share (MS) within treatment-naïve and -experienced populations was equally allocated between telaprevir+PR and boceprevir+PR while SMV+PR MS was 0%; Future MS was 45%, 45%, and 10%, respectively. CHC therapy costs were estimated based on dosing and administration data from US prescribing information and 12/2013 wholesale acquisition costs (assumed 82 kg person). Population allocation by prior response, disease severity, and treatment duration used trials data. Drug-only costs per member per month (PMPM) and per treated CHC member (PTM) were estimated. Sustained virologic response (SVR) absolute values from trials were used to report annual cost per SVR. RESULTS: The model suggested 234 G1 CHC members treated annually. Total health plan’s budget (drug-only costs) was estimated at $1.82 PMPM before and after SMV+PR adoption (incremental cost -$0.001 PMPM). Annual total costs were $93,311 PTM in Current state and $93,271 PTM in Future (incremental cost -$40 PTM). The model calculated the health plan’s annual cost per SVR as $147,105 in Current state and $144,261 in Future for total (treatment-naïve and -experienced) population. Sensitivity analyses doubling or halving the CHC population and increasing SMV+PR MS to 15% or 20% resulted in incremental PMPM drug-only costs of $-0.002 or $0.000 and -$0.001 or -$0.002, respectively. CONCLUSIONS: Modelled drug-only costs results suggest that SMV+PR adoption had an incremental impact to a U.S. health plan budget of -$0.001 PMPM (sensitivity analysis ranged -$0.002-$0.000 PMPM). When the base case considered drug costs plus outcomes, this resulted in a health plan’s total annual cost per SVR decrease of $2,844.
Conference/Value in Health Info
2014-05, ISPOR 2014, Palais des Congres de Montreal
Value in Health, Vol. 17, No. 3 (May 2014)
Code
PIN28
Topic
Economic Evaluation
Topic Subcategory
Budget Impact Analysis
Disease
Infectious Disease (non-vaccine)