OBJECTIVES:

Recent randomized controlled trials (RCTs) and Network meta-analyses suggest that pirfenidone and nintedanib, two therapies for Idiopathic Pulmonary Fibrosis do not differ with respect to their clinical effectiveness. Consequently a Budget Impact Analysis to compare the two based on economic criteria was carried out to contribute useful data for reimbursement decisions.

METHODS:

A model was developed, based on the viewpoint of the Greek national healthcare provider, with a timeline of 4 years, using the national population archives. Two therapeutic scenarios were used, the reference scenario included pirfenidone and basic supportive care (BSC) and the new scenario included nintedanib, pirfendione and BSC. Ex-factory price and BSC costs were based on official pricing documents of the National healthcare provider. Market share in the reference scenario was assumed to be 75% for pirfenidone and 25% for BSC for the entire timeline. In the new scenario market shares for nintedanib, pirfenidone and BSC were considered to be 25%, 65% and 10%, respectively, in the baseline year with an annual market capture rate of 5% for nintedanib in the following years. A one-way sensitivity analysis was conducted on the following parameters: market shares, overall market and therapy costs.

RESULTS:

Total costs for the reference scenario were estimated to be 10m€ for the baseline year and dropped to 9.9m€ for 2019. Total costs for the new scenario were estimated to be 12.19m€ for the baseline year and 12.15m€ for 2019. Incremental costs were estimated to be 8.738m€ in total. The sensitivity analysis demonstrated the stability of these results.

CONCLUSIONS:

The results showed that reimbursement of the new scenario leads to an increased resource burden. The Tornado plot showed that the price of nintedanib was the most important parameter, thus it can be inferred that this is the crucial factor when comparing the two drugs.