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Supplementary materials: The cost–effectiveness of pegcetacoplan in complement treatment-na¨ıve adults with paroxysmal nocturnal hemoglobinuria in the USA

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posted on 2024-04-15, 14:42 authored by Jesse Fishman, Koo Wilson, Aleksandra Drzewiecka, Michal Pochopien, David Dingli

These are peer-reviewed supplementary materials for the article 'The cost–effectiveness of pegcetacoplan in complement treatment-naive adults with paroxysmal nocturnal hemoglobinuria in the USA' published in the Journal of Comparative Effectiveness Research.

  • Supplemental Table 1: Odds ratios between transfusion-avoidant and transfusion-required populations hemoglobin stabilization, pooled arms
  • Supplemental Table 2: Probabilities for transfusion avoidant group – hemoglobin stabilization
  • Supplemental Table 3: Transition probabilities, comparators – hemoglobin stabilization
  • Supplemental Figure 1: Transfusion Required health state structure
  • Supplemental Figure 2: Methodology of calculating transition probabilities for pegcetacoplan+BSC for (A) base-case model structure based on Hb normalization and (B) alternative model structure based on Hb stabilization
  • Supplemental Figure 3: Tornado diagrams of deterministic sensitivity analysis for pegcetacoplan versus (A) eculizumab and (B) ravulizumab
  • Supplemental Figure 4: Incremental cost-effectiveness planes: (A) pegcetacoplan versus eculizumab, (B) pegcetacoplan versus ravulizumab – based on hemoglobin stabilization
  • Supplemental Figure 5: Distribution of patients over time simulated by the CEM for pegcetacoplan, eculizumab, and ravulizumab

Aim: Paroxysmal nocturnal hemoglobinuria (PNH) is a rare blood disorder characterized by hemolytic anemia, bone marrow failure and thrombosis, and is associated with high healthcare burden. We evaluated the cost–effectiveness of pegcetacoplan, a proximal complement-3 inhibitor (C3i), compared with the C5i, eculizumab and ravulizumab, in complement treatment-naive adults with PNH, from the US healthcare payer perspective. Materials & methods: A de novo cost–effectiveness model based on a Markov cohort structure evaluated lifetime (55-year) PNH costs and outcomes. The 6-month cycles of the model reflected the follow-up period of PRINCE (NCT04085601), an open-label trial of pegcetacoplan compared with eculizumab in C5i-naive patients. Data from PRINCE informed the clinical, safety and health-related quality of life outcomes in the model. Results: Pegcetacoplan was associated with lifetime cost savings of $1,176,808 and $213,062 relative to eculizumab and ravulizumab, respectively (largely attributed to reduced drug costs and blood transfusions), and additional quality-adjusted life years (QALYs) of 0.25 and 0.24. Conclusion: In patients with PNH who are treatment-naive, the base-case cost–effectiveness analysis, scenario analysis and sensitivity analysis showed both lifetime cost savings and increased QALYs associated with pegcetacoplan compared with eculizumab or ravulizumab in the USA.

Funding

This study was funded by Apellis Pharmaceuticals, Inc and Swedish Orphan Biovitrum (SOBI) AB, Stockholm, Sweden.

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