Abstract

DIAZ-CEREZO, Silvia; GARCIA-APARICIO, Ángel María; PARRONDO, Javier  and  VALLEJO-APARICIO, Laura Amanda. Cost-effectiveness analysis of Belimumab in patients with systemic lupus erythematosus in Spain. Farm Hosp. [online]. 2015, vol.39, n.3, pp.161-170. ISSN 2171-8695.  https://dx.doi.org/10.7399/fh.2015.39.3.8814.

Objective: To estimate the cost-effectiveness of belimumab in patients with systemic lupus erythematosus (SLE) presenting positive biomarkers and active disease despite standard treatment (ST), from the Spanish social perspective. Methods: A microsimulation model was used to estimate the cost-effectiveness of belimumab plus ST versus ST alone. A treatment duration of two years with a life-time horizon were considered. Efficacy data were obtained from belimumab clinical trials and the evolution of the disease was simulated from John Hopkins' patient cohort data in the United States. Utility data were obtained from literature review. Direct and indirect costs were calculated based on Spanish published data (€, 2014), applying a discount rate (DR) of 3% to both costs and effects. Results were expressed as incremental cost-effectiveness ratio (ICER) in terms of gained life years (LY) and quality of life adjusted life years (QALYs). Probabilistic (PSA) and deterministic sensitivity analyses (DR of 0% and 5%, 5-years treatment duration and excluding indirect costs) were performed to determine the robustness of the model. Results: The incremental cost-effectiveness ratio (ICER) was 16,647€ per life year gained, with an incremental cost-utility ratio (ICUR) of 23,158€ per additional QALY gained. In 68% of the scenarios simulated in the PSA, belimumab was found to be a cost-effective alternative, considering a threshold of 30,000€/QALY. Conclusion: Belimumab can be regarded as a cost-effective alternative from the Spanish social perspective.

Keywords : Cost-effectiveness; Economic model; Belimumab; Systemic lupus erythematosus.

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