An evaluation of vilobelimab (anti-C5a) as a cost-effective option to treat severely ill mechanically ventilated patients with COVID-19.

IF 2.1 4区 医学 Q3 PHARMACOLOGY & PHARMACY
Daniel C Malone, Joseph Biskupiak, Diana Brixner, Gary Oderda, Roger Seheult
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引用次数: 0

Abstract

Disclaimer: In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.

Purpose: COVID-19 patients in intensive care units (ICUs) requiring invasive mechanical ventilation (IMV) have few available treatment options. PANAMO, a multicenter, double-blind, randomized, placebo-controlled phase 3 study of vilobelimab, which blocks the inflammatory process caused by complement component 5a, demonstrated a significant mortality benefit at 28 and 60 days in these patients. A cost-effectiveness analysis was conducted to assess the incremental cost per quality-adjusted life-year (QALY).

Methods: A Markov model was used to estimate QALYs and the incremental cost-effectiveness ratio (ICER) of vilobelimab plus standard of care (SOC) versus SOC alone. The model simulated progression from severe COVID-19 to survival or death over a lifetime horizon. Outcomes data (COVID-19 all-cause mortality and renal replacement therapy) were incorporated from the PANAMO trial. COVID-19 mortality estimates were based on Centers for Disease Control and Prevention age-specific survival data. Utility values and hospital costs came from the literature. Vilobelimab cost was obtained from RED BOOK Online.

Results: For COVID-19 ICU patients, total costs of care were $103,414 (SOC) and $132,247 (SOC plus vilobelimab), respectively, resulting in an incremental cost of $28,833. SOC provided 6.70 QALYs versus 7.99 QALYs for vilobelimab, an additional 1.29 QALYs. The ICER for vilobelimab plus SOC versus SOC alone was $22,287/QALY. Probabilistic sensitivity analysis demonstrated the robustness of the cost-effectiveness result as vilobelimab plus SOC was favored at a willingness-to-pay threshold of $50,000 in over 81% of iterations.

Conclusion: Vilobelimab provides a cost-effective option to treat ICU patients with severe COVID-19 receiving IMV compared to SOC, at well below the commonly accepted $50,000 US willingness-to-pay threshold.

评估维罗贝利单抗(抗 C5a)作为治疗 COVID-19 重型机械通气患者的一种经济有效的选择。
免责声明:为了加快文章的发表,AJHP在接受稿件后会尽快将其发布到网上。被录用的稿件已经过同行评审和校对,但在进行技术格式化和作者校对之前会在网上发布。目的:重症监护病房(ICU)中需要有创机械通气(IMV)的COVID-19患者可选择的治疗方案很少。PANAMO是一项多中心、双盲、随机、安慰剂对照的3期研究,研究对象是阻断由补体成分5a引起的炎症过程的vilobelimab。我们进行了一项成本效益分析,以评估每质量调整生命年(QALY)的增量成本:方法:采用马尔可夫模型估算了QALY以及维罗贝单抗联合标准治疗(SOC)与单用SOC的增量成本效益比(ICER)。该模型模拟了从严重 COVID-19 进展到存活或死亡的整个生命周期。结果数据(COVID-19 全因死亡率和肾脏替代疗法)来自 PANAMO 试验。COVID-19 死亡率估计值基于美国疾病控制和预防中心的特定年龄生存数据。效用值和住院费用来自文献。Vilobelimab的费用来自RED BOOK Online:对于 COVID-19 ICU 患者,护理总成本分别为 103,414 美元(SOC)和 132,247 美元(SOC 加维洛贝单抗),增量成本为 28,833 美元。 SOC 提供了 6.70 QALYs,而维洛贝单抗提供了 7.99 QALYs,增加了 1.29 QALYs。维罗单抗联合 SOC 与单用 SOC 相比,ICER 为 22,287 美元/QALY。概率敏感性分析表明了成本效益结果的稳健性,因为在超过81%的迭代中,当支付意愿阈值为50,000美元时,维罗单抗加SOC更受青睐:与SOC相比,Vilobelimab为接受IMV治疗的ICU重症COVID-19患者提供了一种具有成本效益的选择,其治疗成本远低于公认的50,000美元支付意愿阈值。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
2.90
自引率
18.50%
发文量
341
审稿时长
3-8 weeks
期刊介绍: The American Journal of Health-System Pharmacy (AJHP) is the official publication of the American Society of Health-System Pharmacists (ASHP). It publishes peer-reviewed scientific papers on contemporary drug therapy and pharmacy practice innovations in hospitals and health systems. With a circulation of more than 43,000, AJHP is the most widely recognized and respected clinical pharmacy journal in the world.
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