Cost-effectiveness analysis of anifrolumab therapy in patients with systemic lupus erythematosus in the Russian Federation

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OBJECTIVE

Cost-effectiveness analysis of anifrolumab therapy in adults with moderate-to-severe systemic lupus erythematosus in the Russian Federation.

MATERIAL AND METHODS

We performed cost-effectiveness analysis to assess incremental cost-effectiveness ratio (ICER) for anifrolumab compared to belimumab in addition to standard therapy. Considering the results of indirect comparison, we established the criteria of effectiveness. Analysis of costs was based on government procurement of drugs and registered prices of drugs from the list of vital and essential drugs. Dosages of drugs were determined in accordance with instructions and clinical recommendations. Finally, we performed a sensitivity analysis varying the input parameters.

RESULTS

Anifrolumab has a significant advantage in effectiveness compared to belimumab. The odds ratio for response to therapy (SRI-4 criterion) is 2.61 (95% CI 1.22—5.58). The cost of 52-week anifrolumab therapy in addition to standard therapy is 1.3 million rubles per a patient, the cost of belimumab therapy — 0.62 million rubles. Additional costs per a patient with SRI-4 response (ICER) amounted to 3.49 million rubles when using anifrolumab compared to belimumab. This value is lower than ICER for belimumab in addition to standard therapy compared to standard therapy (5.08 million rubles). Sensitivity analysis demonstrates robustness of results to varyability of input values.

CONCLUSION

Clinical effectiveness of anifrolumab therapy is significantly higher compared to belimumab according to SRI-4 criterion, but this therapy requires greater costs. Incremental cost for achieving SRI-4 response in 1 additional patient is 31.15% lower for anifrolumab compared to belimumab than for belimumab compared to standard therapy. Therefore, anifrolumab therapy is economically feasible in patients with moderate-to-severe systemic lupus erythematosus.

Keywords:

systemic lupus erythematosus

anifrolumab

belimumab

cost-effectiveness analysis

Authors:

Pyadushkina E.A.

National Center for Health Technology Assessment

ORCID: 0000-0002-4173-2027

Ignatieva V.I.

National Medical Research Center for Therapy and Preventive Medicine;
I.M. Sechenov First Moscow State Medical University (Sechenov University);
Russian Medical Academy of Continuing Professional Education

ORCID: 0000-0001-6789-9514

Yagnenkova E.E.

National Center for Health Technology Assessment

ORCID: 0000-0002-3553-1835

Derkach E.V.

National Center for Health Technology Assessment

ORCID: 0000-0002-6207-9936

Received:

07.09.2023

Accepted:

19.09.2023

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