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Cost-minimization Analysis of Damoctocog Alfa Pegol in severe Hemophilia A in Greece
Vellopoulou K, Georgilis A, Byrne A, Gray E, De Meyer N, Kourlaba G Value in Health. 2019;22:S848. https://doi.org/10.1016/j.jval.2019.09.2371
Objectives: To compare the costs of an extended-half life (EHL) recombinant factor VIII (rFVIII), the damoctocog alfa pegol (DaPeg) with other EHL and standard-acting (SA) factors for prophylactic and on-demand (OD) treatment of severe haemophilia A (HemA) in patients ≥12 years in Greece, from the public payer perspective.
Methods: A Μarkov cost-minimization model with annual cycles was locally adapted to estimate the treatment cost associated with DaPeg, efmoroctocog-alfa, turoctocog-alfa, moroctocog-alfa and octocog-alfa (rAHF-PFM, BAY81-8973) for adolescents (12-18y) and adults with severe HemA. This structure was supported by a matching-adjusted indirect comparison that demonstrated there was no statistically significant difference in the annual bleeding rate (ABR) among the included treatment regimens. The ABR was set at 3.7 for patients treated prophylactically and 19.77 and 21.49 for adolescents and adults treated on-demand (OD), respectively. Resource use included only the factor consumption (dose IU/kg) in prophylaxis and OD for adults and adolescents, separately. Annual prophylactic and OD dosing were retrieved from the SPC and clinical trial of each drug, respectively. Model inputs were validated by 3 experts. National data on weight and mortality were applied. Drug costs were obtained from official sources (€, 2018) using a discount rate of 3.5%.
Results: Across all available rFVIII products, DaPeg was found to be associated with a cost saving ranging from 2% vs efmoroctocog-alfa and rAHF-PFM to 18% vs BAY81-8973, over a lifetime horizon. Compared to other EHLs, DaPeg results in cost savings of €52,206 per patient, with a 16.5% less factor utilization. Following moroctocog-alfa, DaPeg was estimated to be the 2nd least costly treatment option.
Conclusions: For the treatment of patients with severe HemA in Greece, DaPeg was a cost-saving option compared to existing EHL and most of the SA rFVIIIs molecules from the public payer perspective.