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Modeling SLE Treatment Cost-Effectiveness Based on a Novel LLDAS Treat-to-Target Approach.

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A new model shows anifrolumab is cost-effective for systemic lupus erythematosus (SLE) by targeting Lupus Low Disease Activity State (LLDAS). This approach uses treat-to-target strategies to assess treatment value in SLE patients.

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Area of Science:

  • Rheumatology
  • Health Economics
  • Pharmacoeconomics

Background:

  • Systemic lupus erythematosus (SLE) is a chronic autoimmune disease requiring long-term management.
  • Current treatment strategies aim to achieve low disease activity, but cost-effectiveness modeling needs refinement.
  • Treat-to-target approaches, like Lupus Low Disease Activity State (LLDAS), offer a framework for optimizing SLE management.

Purpose of the Study:

  • To introduce and validate a novel cost-effectiveness modeling approach for SLE treatments.
  • To evaluate the cost-effectiveness of anifrolumab compared to standard of care (SOC) using LLDAS-defined health states.
  • To integrate disease activity, corticosteroid use, and organ damage into a comprehensive economic model.

Main Methods:

  • A Markov Cohort State Transition Model was employed.
  • The model incorporated 24 health states based on LLDAS status and Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI) scores.
  • Data for transition probabilities, costs, and utilities were sourced from observational studies and the TULIP trial.

Main Results:

  • Anifrolumab resulted in incremental costs of $17,605 and 0.147 quality-adjusted life years (QALYs) compared to SOC, yielding an incremental cost-effectiveness ratio (ICER) of $119,841/QALY.
  • Sensitivity analyses confirmed the base case findings, with LLDAS attainment rates at Week 24 being the most influential parameter on the ICER.
  • Mortality differences between LLDAS states and health-related quality of life also impacted the ICER.

Conclusions:

  • The developed model provides a robust and straightforward method for assessing the cost-effectiveness of SLE therapies.
  • This approach effectively utilizes validated treat-to-target goals, such as LLDAS, for evaluating treatments in SLE.
  • The model supports informed decision-making regarding the economic value of novel SLE interventions.