OBJECTIVES: The current clinical practice for the management of patients with Idiopathic Pulmonary Fibrosis (IPF) includes two alternative therapeutic options, pirfenidone and nintedanib. The analysis aimed at evaluating their efficiency within the Greek healthcare system by comparing their annual cost per response rate from a payer’s perspective.

METHODS: In assessing the efficiency of the two therapeutic options, the cost per response rate was estimated to reflect the annual drug cost for achieving a rate of decline not more than 10 percentage points in the % predicted FVC, an endpoint consistent with a slowing of disease progression and clinical stabilization. Clinical data for the IPF patient populations of mild-to-moderate physiological impairment were derived from pirfenidone’s ASCEND & CAPACITY 1 & 2 trials (weighted average) and nintedanib’s INPULSIS 1 & 2 trials. For each therapeutic option, respective costing data of drug acquisition were obtained from official government sources (values in €, 2017).

RESULTS: The analysis estimated that the annual costs to achieve clinical stabilization was €27.856 and €31.802 with pirfenidone and nintedanib, respectively. The difference in the annual cost per response rate between the two alternatives was in favor of pirfenidone with generated savings of €3.947 (€31.802 vs €27.856). For the treated IPF patient population, results indicate that the savings realized from treating patients with pirfenidone instead of nintedanib could be invested in covering the annual cost for 17% more IPF patients receiving therapy with pirfenidone or for 14% more IPF patients reaching clinical stability.

CONCLUSIONS: Within the Greek healthcare environment of scarce resources and significant budget constraints, the annual cost per response rate indicates that pirfenidone constitutes a cost-saving therapeutic alternative to nintedanib for the treatment of patients with mild-to-moderate IPF and yields sufficient savings to treat and stabilize disease progression for more patients compared to its competitor.