Cost-effectiveness of ruxolitinib in Singapore for patients with chronic graft-versus-host disease.

IF 1.5 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Expert Review of Pharmacoeconomics & Outcomes Research Pub Date : 2025-07-07 DOI:10.1080/14737167.2025.2529366

Naren Kumar Surendra, Jiamin Ong, Xin Yi Wong, Michelle Poon, Lydia Loke, Liang Lin, Mohamed Ismail Abdul Aziz, Benjamin Shao Kiat Ong, Kwong Ng

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引用次数: 0

Abstract

Objective: To evaluate the cost-effectiveness of ruxolitinib in Singapore for patient with chronic graft-versus-host disease (GVHD) and inadequate response to corticosteroids.

Methods: A three-state partitioned survival model was developed to evaluate the cost-effectiveness of ruxolitinib from the Singapore healthcare system perspective over a five-year time horizon. Clinical data were sourced from the REACH3 trial, health state utilities were retrieved from literature, and direct costs were obtained from public healthcare institutions in Singapore. Sensitivity and scenario analyses were conducted to explore the impact of uncertainties and assumptions on the cost-effectiveness results.

Results: Compared to best available therapy, ruxolitinib yielded a base-case incremental cost-effectiveness ratio (ICER) of S$776,653 (US$574,724) per quality-adjusted life-years gained. Sensitivity analyses revealed that the ICER was particularly sensitive to utilities in failure-free and progressed disease states. Scenario analyses confirmed that the ICERs remained high even under favorable assumptions, and a substantial price reduction was necessary to lower the ICER.

Conclusion: At its current price, ruxolitinib is not cost-effective for treating chronic GVHD in Singapore. This finding helps to inform funding decision-making, which also considers other factors such as clinical effectiveness, safety, and budget impact, in addition to cost-effectiveness.

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鲁索利替尼在新加坡治疗慢性移植物抗宿主病患者的成本效益

目的：在新加坡评估ruxolitinib治疗慢性移植物抗宿主病（GVHD）和糖皮质激素反应不足患者的成本-效果。方法：开发了一个三状态分区生存模型，从新加坡医疗保健系统的角度评估ruxolitinib在五年时间范围内的成本效益。临床数据来自REACH3试验，健康国家公用事业从文献中检索，直接成本来自新加坡的公共医疗机构。进行敏感性和情景分析，探讨不确定性和假设对成本效益结果的影响。结果：与最佳可用疗法相比，ruxolitinib获得的每质量调整生命年QALY的基本病例增量成本-效果比（ICER）为776,653新元（574,724美元）。敏感性分析显示，在无故障和疾病进展状态下，ICER对公用事业特别敏感。情景分析证实，即使在有利的假设下，ICERs仍然很高，并且需要大幅降低价格以降低ICERs。结论：在新加坡，以目前的价格，ruxolitinib治疗慢性GVHD不具有成本效益。这一发现有助于为资助决策提供信息，除了成本效益外，还考虑其他因素，如临床有效性、安全性和预算影响。

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

Expert Review of Pharmacoeconomics & Outcomes Research HEALTH CARE SCIENCES & SERVICES-PHARMACOLOGY & PHARMACY

CiteScore

4.00

自引率

4.30%

发文量

审稿时长

6-12 weeks

期刊介绍： Expert Review of Pharmacoeconomics & Outcomes Research (ISSN 1473-7167) provides expert reviews on cost-benefit and pharmacoeconomic issues relating to the clinical use of drugs and therapeutic approaches. Coverage includes pharmacoeconomics and quality-of-life research, therapeutic outcomes, evidence-based medicine and cost-benefit research. All articles are subject to rigorous peer-review. The journal adopts the unique Expert Review article format, offering a complete overview of current thinking in a key technology area, research or clinical practice, augmented by the following sections: Expert Opinion – a personal view of the data presented in the article, a discussion on the developments that are likely to be important in the future, and the avenues of research likely to become exciting as further studies yield more detailed results Article Highlights – an executive summary of the author’s most critical points.