TY - JOUR
T1 - Economic Evaluation of Immune Tolerance Induction in Children With Severe Hemophilia A and High-Responding Inhibitors
T2 - A Cost-Effectiveness Analysis of Prophylaxis With Emicizumab
AU - Camelo, Ricardo Mesquita
AU - Barbosa, Mariana Michel
AU - Araújo, Maiara Silva
AU - Muniz, Roberto Lúcio
AU - Guerra, Augusto Afonso
AU - Godman, Brian
AU - Rezende, Suely Meireles
AU - Acurcio, Francisco de Assis
AU - Martin, Antony P.
AU - Alvares-Teodoro, Juliana
N1 - Publisher Copyright:
© 2022 International Society for Health Economics and Outcomes Research
PY - 2023/3
Y1 - 2023/3
N2 - Objective: This study aimed to measure the cost-effectiveness of prophylaxis with emicizumab in PsHAhri on ITI in Brazil. Methods: A cost-effectiveness modeling analysis was used to estimate the costs per PsHAhri on ITI and the number of prevented bleedings from undertaking one intervention (prophylaxis with BpA) over another (prophylaxis with emicizumab), based on the Brazilian Ministry of Health perspective. Costs of ITI with recombinant FVIII, prophylaxis with BpA or emicizumab, and treated bleeding episodes with BpA costs were evaluated for PsHAhri who had ITI success or failure. This study was conducted with the perspective of the Brazilian Ministry of Health (payer). Results: During ITI, prophylaxis with BpA cost US $924 666/PsHAhri/ITI, whereas prophylaxis with emicizumab cost US $488 785/PsHAhri/ITI. During ITI, there was an average of 9.32 bleeding episodes/PsHAhri/ITI when BpA were used as prophylaxis and 0.67 bleeding/PsHAhri/ITI when emicizumab was used. By univariate deterministic sensitivity analysis, emicizumab remained dominant whichever variable was modified. Conclusion: In this study, prophylaxis with emicizumab during ITI is a dominant option compared with prophylaxis with BpA during ITI.
AB - Objective: This study aimed to measure the cost-effectiveness of prophylaxis with emicizumab in PsHAhri on ITI in Brazil. Methods: A cost-effectiveness modeling analysis was used to estimate the costs per PsHAhri on ITI and the number of prevented bleedings from undertaking one intervention (prophylaxis with BpA) over another (prophylaxis with emicizumab), based on the Brazilian Ministry of Health perspective. Costs of ITI with recombinant FVIII, prophylaxis with BpA or emicizumab, and treated bleeding episodes with BpA costs were evaluated for PsHAhri who had ITI success or failure. This study was conducted with the perspective of the Brazilian Ministry of Health (payer). Results: During ITI, prophylaxis with BpA cost US $924 666/PsHAhri/ITI, whereas prophylaxis with emicizumab cost US $488 785/PsHAhri/ITI. During ITI, there was an average of 9.32 bleeding episodes/PsHAhri/ITI when BpA were used as prophylaxis and 0.67 bleeding/PsHAhri/ITI when emicizumab was used. By univariate deterministic sensitivity analysis, emicizumab remained dominant whichever variable was modified. Conclusion: In this study, prophylaxis with emicizumab during ITI is a dominant option compared with prophylaxis with BpA during ITI.
KW - activated prothrombin complex concentrate
KW - bypassing agents
KW - cost-effectiveness analysis
KW - emicizumab
KW - immune tolerance induction
KW - prophylaxis
KW - recombinant activated factor VII
UR - http://www.scopus.com/inward/record.url?scp=85143543632&partnerID=8YFLogxK
U2 - 10.1016/j.vhri.2022.10.007
DO - 10.1016/j.vhri.2022.10.007
M3 - Article
C2 - 36463835
AN - SCOPUS:85143543632
SN - 2212-1099
VL - 34
SP - 31
EP - 39
JO - Value in Health Regional Issues
JF - Value in Health Regional Issues
ER -
