PMID- 38126738
OWN - NLM
STAT- MEDLINE
DCOM- 20240129
LR  - 20240206
IS  - 1744-8379 (Electronic)
IS  - 1473-7167 (Linking)
VI  - 24
IP  - 2
DP  - 2024 Feb
TI  - A projected cost-utility analysis of avacopan for the treatment of antineutrophil 
      cytoplasmic antibody-associated vasculitis in Spain.
PG  - 227-235
LID - 10.1080/14737167.2023.2297790 [doi]
AB  - BACKGROUND: Antineutrophil cytoplasmic antibody-associated vasculitis (AAV) are 
      rare autoimmune diseases characterized by inflammation of blood vessels. This 
      study aimed to assess the cost-utility of avacopan in combination with rituximab 
      (RTX) or cyclophosphamide (CYC) compared with glucocorticoids (GC) for the 
      treatment of severe, active AAV in Spain. METHODS: A 9-state Markov model was 
      designed to reflect the induction of remission and sustained remission of AAV 
      over a lifetime horizon. Clinical data and utility values were mainly obtained 
      from the ADVOCATE trial, and costs (euro 2022) were sourced from national databases. 
      Quality-adjusted life years (QALYs), and incremental cost-utility ratio (ICUR) 
      were evaluated. An annual discount rate of 3% was applied. Sensitivity analyses 
      were performed to examine the robustness of the results. RESULTS: Avacopan 
      yielded an increase in effectiveness (6.52 vs. 6.17 QALYs) and costs (euro16,009) 
      compared to GC, resulting in an ICUR of euro45,638 per additional QALY gained. 
      Avacopan was associated with a lower incidence of end-stage renal disease (ESRD), 
      relapse and hospitalization-related adverse events. Sensitivity analyses 
      suggested that the model outputs were robust and that the progression to ESRD was 
      a driver of ICUR. CONCLUSIONS: Avacopan is a cost-effective option for patients 
      with severe, active AAV compared to GC in Spain.
FAU - Macia, Manuel
AU  - Macia M
AD  - Nephrology Service, Hospital Universitario Nuestra Senora de Candelaria, Santa 
      Cruz de Tenerife, Spain.
FAU - Diaz-Encarnacion, Montserrat
AU  - Diaz-Encarnacion M
AD  - Nephrology Service, Fundacio Puigvert, Barcelona, Spain.
FAU - Solans-Laque, Roser
AU  - Solans-Laque R
AD  - Internal Medicine Department, Hospital Valle de Hebron, Barcelona, Spain.
FAU - Mallol, Elisenda Pomares
AU  - Mallol EP
AD  - Market Access, PharmaLex, Barcelona, Spain.
FAU - Castells, Alejandra Garcia
AU  - Castells AG
AD  - Market Access, PharmaLex, Barcelona, Spain.
FAU - Escribano, Cristina
AU  - Escribano C
AD  - Medical Department, CSL Vifor, Barcelona, Spain.
FAU - de Arellano, Antonio Ramirez
AU  - de Arellano AR
AD  - HEOR, CSL Vifor, Zurich, Switzerland.
LA  - eng
PT  - Journal Article
DEP - 20240125
PL  - England
TA  - Expert Rev Pharmacoecon Outcomes Res
JT  - Expert review of pharmacoeconomics & outcomes research
JID - 101132257
RN  - 0 (Antibodies, Antineutrophil Cytoplasmic)
RN  - O880NM097T (avacopan)
RN  - 4F4X42SYQ6 (Rituximab)
RN  - 0 (Glucocorticoids)
RN  - 0 (Aniline Compounds)
RN  - 0 (Nipecotic Acids)
SB  - IM
MH  - Humans
MH  - Antibodies, Antineutrophil Cytoplasmic/therapeutic use
MH  - Cost-Benefit Analysis
MH  - *Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/drug 
      therapy/chemically induced
MH  - Spain
MH  - Remission Induction
MH  - Rituximab
MH  - Glucocorticoids/adverse effects
MH  - *Kidney Failure, Chronic
MH  - *Aniline Compounds
MH  - *Nipecotic Acids
OTO - NOTNLM
OT  - Avacopan
OT  - competitive C5a receptor antagonist
OT  - cost-utility analysis
OT  - granulomatosis with polyangiitis
OT  - microscopic polyangiitis
OT  - vasculitis
EDAT- 2023/12/21 12:41
MHDA- 2024/01/29 06:44
CRDT- 2023/12/21 08:53
PHST- 2024/01/29 06:44 [medline]
PHST- 2023/12/21 12:41 [pubmed]
PHST- 2023/12/21 08:53 [entrez]
AID - 10.1080/14737167.2023.2297790 [doi]
PST - ppublish
SO  - Expert Rev Pharmacoecon Outcomes Res. 2024 Feb;24(2):227-235. doi: 
      10.1080/14737167.2023.2297790. Epub 2024 Jan 25.