The Fiscal Consequences for the Canadian Government of Efgartigimod in the Treatment of Generalized Myasthenia Gravis.

IF 2.3 Q2 ECONOMICS

Journal of Health Economics and Outcomes Research Pub Date : 2026-03-11 eCollection Date: 2026-01-01 DOI:10.36469/001c.157709

Ana Teresa Paquete, Mark P Connolly, Cynthia Qi, Hans Katzberg, Syed Raza, Charles Kassardjian, Zaeem A Siddiqi, Roger Kaprielian, Jason Locklin, Glenn A Phillips, Nikos Kotsopoulos

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Objectives: To value the fiscal consequences of treating adults with acetylcholine receptor-antibody positive (AChR-Ab+) gMG with efgartigimod vs current treatments. The lifetime impact on people living with gMG and their caregivers is considered from the perspective of Canada's public accounts. Methods: A lifetime Markov cohort simulation following adults with gMG according to their Activities of Daily Living (MG-ADL) score was linked to labor and fiscal stages of both patients and care- givers. Based on the MyRealWorld MG study, MG-ADL scores defined the labor market characteristics of both individuals with gMG and their caregivers. National statistics data on sex- and age-specific labor outcomes were used to model patients with minimal symptoms. Benefit payments and tax revenue losses attributable to gMG were estimated and valued according to national official sources. Public healthcare costs were included. The difference between efgartigimod and current treatments was assessed by discounted lifetime incremental fiscal consequences. Sensitivity analyses were applied to the fiscal parameters. Results: Without active treatments, the lifetime fiscal burden associated with individuals with gMG and their caregivers was estimated at CAD <math><mn>1.24</mn> <mi>m</mi> <mi>i</mi> <mi>l</mi> <mi>l</mi> <mi>i</mi> <mi>o</mi> <mi>n</mi> <mi>i</mi> <mi>n</mi> <mi>g</mi> <mi>o</mi> <mi>v</mi> <mi>e</mi> <mi>r</mi> <mi>n</mi> <mi>m</mi> <mi>e</mi> <mi>n</mi> <mi>t</mi> <mi>e</mi> <mi>x</mi> <mi>p</mi> <mi>e</mi> <mi>n</mi> <mi>d</mi> <mi>i</mi> <mi>t</mi> <mi>u</mi> <mi>r</mi> <mi>e</mi> <mi>s</mi> <mo>.</mo> <mi>C</mi> <mi>o</mi> <mi>m</mi> <mi>p</mi> <mi>a</mi> <mi>r</mi> <mi>e</mi> <mi>d</mi> <mi>w</mi> <mi>i</mi> <mi>t</mi> <mi>h</mi> <mi>t</mi> <mi>h</mi> <mi>e</mi> <mi>c</mi> <mi>u</mi> <mi>r</mi> <mi>r</mi> <mi>e</mi> <mi>n</mi> <mi>t</mi> <mi>w</mi> <mi>e</mi> <mi>i</mi> <mi>g</mi> <mi>h</mi> <mi>t</mi> <mi>e</mi> <mi>d</mi> <mi>b</mi> <mi>u</mi> <mi>n</mi> <mi>d</mi> <mi>l</mi> <mi>e</mi> <mi>o</mi> <mi>f</mi> <mi>t</mi> <mi>r</mi> <mi>e</mi> <mi>a</mi> <mi>t</mi> <mi>m</mi> <mi>e</mi> <mi>n</mi> <mi>t</mi> <mi>s</mi> <mi>i</mi> <mi>n</mi> <mi>C</mi> <mi>a</mi> <mi>n</mi> <mi>a</mi> <mi>d</mi> <mi>a</mi> <mo>,</mo> <mi>e</mi> <mi>f</mi> <mi>g</mi> <mi>a</mi> <mi>r</mi> <mi>t</mi> <mi>i</mi> <mi>g</mi> <mi>i</mi> <mi>m</mi> <mi>o</mi> <mi>d</mi> <mi>w</mi> <mi>a</mi> <mi>s</mi> <mi>e</mi> <mi>s</mi> <mi>t</mi> <mi>i</mi> <mi>m</mi> <mi>a</mi> <mi>t</mi> <mi>e</mi> <mi>d</mi> <mi>t</mi> <mi>o</mi> <mi>s</mi> <mi>a</mi> <mi>v</mi> <mi>e</mi> <mi>C</mi> <mi>A</mi> <mi>D</mi></math> 458 754 per treated adult. Results were sensitive to the distribution of the bundle of treatments. Discussion: Beyond healthcare costs, gMG severely impacts productivity and governmental accounts. Decision-makers should be provided evidence of fiscal consequences when assessing healthcare technologies. The public sector in Canada was estimated to have a return of CAD <math><mn>1.58</mn> <mi>p</mi> <mi>e</mi> <mi>r</mi> <mi>e</mi> <mi>v</mi> <mi>e</mi> <mi>r</mi> <mi>y</mi> <mi>C</mi> <mi>A</mi> <mi>D</mi></math> 1 spent on efgartigimod for people with gMG compared with the current bundle of treatments. Conclusions: Improving health outcomes and reducing the need for informal caregivers benefits those affected by gMG and governmental accounts.","PeriodicalId":16012,"journal":{"name":"Journal of Health Economics and Outcomes Research","volume":"13 1","pages":"85-92"},"PeriodicalIF":2.3000,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12986971/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Health Economics and Outcomes Research","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.36469/001c.157709","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"ECONOMICS","Score":null,"Total":0}

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Abstract

Background: Generalized myasthenia gravis (gMG) severely impacts activities of daily living. Productivity losses and the need for care can impact household finances and consequently government public accounts. This study adopts a governmental perspective framework to assess the fiscal consequences of treating gMG that is inadequately controlled by standard therapy, beyond healthcare costs. Savings in tax revenue loss and benefit payments are considered. Objectives: To value the fiscal consequences of treating adults with acetylcholine receptor-antibody positive (AChR-Ab+) gMG with efgartigimod vs current treatments. The lifetime impact on people living with gMG and their caregivers is considered from the perspective of Canada's public accounts. Methods: A lifetime Markov cohort simulation following adults with gMG according to their Activities of Daily Living (MG-ADL) score was linked to labor and fiscal stages of both patients and care- givers. Based on the MyRealWorld MG study, MG-ADL scores defined the labor market characteristics of both individuals with gMG and their caregivers. National statistics data on sex- and age-specific labor outcomes were used to model patients with minimal symptoms. Benefit payments and tax revenue losses attributable to gMG were estimated and valued according to national official sources. Public healthcare costs were included. The difference between efgartigimod and current treatments was assessed by discounted lifetime incremental fiscal consequences. Sensitivity analyses were applied to the fiscal parameters. Results: Without active treatments, the lifetime fiscal burden associated with individuals with gMG and their caregivers was estimated at CAD $1.24 m i l l i o n i n g o v e r n m e n t e x p e n d i t u r e s . C o m p a r e d w i t h t h e c u r r e n t w e i g h t e d b u n d l e o f t r e a t m e n t s i n C a n a d a, e f g a r t i g i m o d w a s e s t i m a t e d t o s a v e C A D$ 458 754 per treated adult. Results were sensitive to the distribution of the bundle of treatments. Discussion: Beyond healthcare costs, gMG severely impacts productivity and governmental accounts. Decision-makers should be provided evidence of fiscal consequences when assessing healthcare technologies. The public sector in Canada was estimated to have a return of CAD $1.58 p e r e v e r y C A D$ 1 spent on efgartigimod for people with gMG compared with the current bundle of treatments. Conclusions: Improving health outcomes and reducing the need for informal caregivers benefits those affected by gMG and governmental accounts.

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艾夫加替莫德治疗广泛性重症肌无力对加拿大政府的财政影响。

背景：全身性重症肌无力（gMG）严重影响日常生活活动。生产力损失和护理需求会影响家庭财务，进而影响政府公共账户。本研究采用政府视角框架来评估治疗标准疗法控制不充分的gMG的财政后果，超出医疗保健费用。考虑了税收损失和福利金的节省。目的：评价艾加替吉莫德治疗成人乙酰胆碱受体抗体阳性（AChR-Ab+） gMG的财政后果与目前的治疗方法。从加拿大公共账户的角度考虑对gMG患者及其照顾者的终身影响。方法：根据日常生活活动（MG-ADL）评分，对成人gMG进行终身马尔可夫队列模拟，将其与患者和护理人员的劳动和财政阶段联系起来。基于MyRealWorld的MG研究，MG- adl分数定义了gMG患者及其照顾者的劳动力市场特征。针对特定性别和年龄的分娩结果的国家统计数据被用于对症状最小的患者进行建模。根据国家官方资料估计和评估了可归因于gMG的福利金支付和税收损失。公共医疗费用也包括在内。efgartigimod与当前治疗方法之间的差异通过贴现终身增量财政后果来评估。对财政参数进行敏感性分析。结果：在没有积极治疗的情况下，与gMG患者及其护理人员相关的终生经济负担估计为124万加元/年/年/年/年/年/年/年/年/年/年/年/年/年/年/年/年/年/年/年/年/年/年/年/年/年。C o m p r e d w i t h t h e C u r r e n t w e i g h t e d b u n d l e o f t r e t m e n t s n C n d, e g f r t i g i m o d w s e s t i m t e d t o s v e C d 458 754 /成人治疗。结果对治疗束的分布较为敏感。讨论：除了医疗成本之外，gMG还严重影响生产力和政府账户。在评估医疗保健技术时，应向决策者提供财政后果的证据。与目前的一揽子治疗相比，加拿大的公共部门估计每年将获得1.58加元的回报，而在治疗gMG患者的药物治疗上花费的费用为1亿加元。结论：改善健康结果和减少对非正式照护者的需求有利于受gMG和政府账户影响的人。

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