PMID- 32960433
OWN - NLM
STAT- MEDLINE
DCOM- 20210917
LR  - 20210917
IS  - 1179-2027 (Electronic)
IS  - 1170-7690 (Linking)
VI  - 38
IP  - 12
DP  - 2020 Dec
TI  - Cost Effectiveness of Teplizumab for Prevention of Type 1 Diabetes Among 
      Different Target Patient Groups.
PG  - 1359-1372
LID - 10.1007/s40273-020-00962-y [doi]
AB  - OBJECTIVE: Teplizumab was recently shown to be the first-ever drug to prevent or 
      delay type 1 diabetes mellitus onset in at-risk individuals, especially those 
      with certain genetic and antibody characteristics. However, its potentially high 
      price may pose challenges for coverage and reimbursement for payers and 
      policymakers. Thus, it is critical to investigate the cost effectiveness of this 
      drug for different target individuals. RESEARCH DESIGN AND METHODS: Using Markov 
      microsimulation modeling, we compared the cost effectiveness of five options for 
      choosing target individuals (i.e., all at-risk individuals, individuals without 
      human leukocyte antigen (HLA)-DR3 or with HLA-DR4 allele, individuals without 
      HLA-DR3 and with HLA-DR4 allele, individuals with anti-zinc transporter 8 (ZnT8) 
      antibody negative, and no provision at all) at different possible prices of 
      teplizumab. Effectiveness was measured by quality-adjusted life-years. Costs were 
      estimated from a health system perspective. RESULTS: If the price of teplizumab 
      is below US$48,900, treating all at-risk individuals is cost effective. However, 
      it will be cost effective to treat only individuals without HLA-DR3 or with 
      HLA-DR4 alleles for prices between US$48,900 and US$58,200, only individuals both 
      without HLA-DR3 and with HLA-DR4 alleles for prices between US$58,200 and 
      US$88,300, and only individuals with negative ZnT8 antibody status for prices 
      between US$88,300 and US$193,700. CONCLUSIONS: Cost-effective provision of 
      teplizumab to target individuals depends on the price of teplizumab and genetic 
      and antibody characteristics of treated individuals. As the drug makes its way to 
      the market, findings from this study will help inform policymakers and payers on 
      cost-effective ways to provide this innovative but expensive drug to at-risk 
      individuals.
FAU - Mital, Shweta
AU  - Mital S
AD  - School of Pharmacy, Memorial University of Newfoundland, 300 Prince Philip Drive, 
      St. John's, NL, A1B 3V6, Canada.
FAU - Nguyen, Hai V
AU  - Nguyen HV
AD  - School of Pharmacy, Memorial University of Newfoundland, 300 Prince Philip Drive, 
      St. John's, NL, A1B 3V6, Canada. hvnguyen@mun.ca.
LA  - eng
PT  - Journal Article
DEP - 20200922
PL  - New Zealand
TA  - Pharmacoeconomics
JT  - PharmacoEconomics
JID - 9212404
RN  - 0 (Antibodies, Monoclonal, Humanized)
RN  - 0 (HLA-DR3 Antigen)
RN  - S4M959U2IJ (teplizumab)
MH  - Alleles
MH  - Antibodies, Monoclonal, Humanized
MH  - Cost-Benefit Analysis
MH  - *Diabetes Mellitus, Type 1/drug therapy/genetics
MH  - HLA-DR3 Antigen/genetics
MH  - Humans
EDAT- 2020/09/23 06:00
MHDA- 2021/09/18 06:00
CRDT- 2020/09/22 12:13
PHST- 2020/08/31 00:00 [accepted]
PHST- 2020/09/23 06:00 [pubmed]
PHST- 2021/09/18 06:00 [medline]
PHST- 2020/09/22 12:13 [entrez]
AID - 10.1007/s40273-020-00962-y [pii]
AID - 10.1007/s40273-020-00962-y [doi]
PST - ppublish
SO  - Pharmacoeconomics. 2020 Dec;38(12):1359-1372. doi: 10.1007/s40273-020-00962-y. 
      Epub 2020 Sep 22.