PMID- 38259264 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240124 IS - 1663-9812 (Print) IS - 1663-9812 (Electronic) IS - 1663-9812 (Linking) VI - 14 DP - 2023 TI - Comparative pharmacoeconomic analysis of rituximab and traditional tacrolimus regimens in membranous nephropathy in China. PG - 1309930 LID - 10.3389/fphar.2023.1309930 [doi] LID - 1309930 AB - Background: Rituximab (RTX) is a monoclonal antibody that selectively targets CD20 and is frequently used in the treatment of membranous nephropathy (MN). Analysis of the therapeutic efficacy and safety of RTX in treating MN in practice and a comparative pharmacoeconomic analysis of the RTX and traditional tacrolimus (TAC) regimens can provide valuable insights to aid decision-making by the government and relevant medical insurance departments. Methods: We conducted a statistical analysis of medical records from patients diagnosed with MN who underwent RTX treatment between 1 January 2019 and 1 January 2023. The TAC data were obtained from the clinical literature. The efficacy rates and incidence of adverse effects (AEs) were calculated to compare the efficacy and safety of RTX and TAC. Based on the patient's disease status, we developed a Markov model to compare the total cost, remission rate, and incremental cost-effectiveness ratio (ICER) of the two regimens. Both univariate and probability sensitivity analyses were performed to validate the stability of the developed model. Results: The RTX group enrolled 53 patients with MN, and the 12-month overall efficacy rate was not significantly different from that of the TAC group with 35 patients (86.79% vs. 71.4%, p = 0.0131); however, the relapse rate was significantly lower in the RTX group (3.77% vs. 22.8%, p = 0.016). The RTX group demonstrated no severe AEs (SAEs), while the TAC group demonstrated six cases of SAEs, including 4 cases of severe pneumonia, 1 case of lung abscess and 1 case of interstitial lung disease, accounting for 7.89% of traditional tacrolimus-treated patients. The baseline analysis results revealed that over a 5-year post-treatment period, RTX increased quality-adjusted life years (QALYs) by 0.058 and costs by yen7,341. Assuming three times the 2022 domestic gross domestic product as the willingness-to-pay (WTP) threshold per QALY, the ICER of RTX compared to TAC was yen124,631.14/QALY, which is less than the WTP threshold of yen257,094/QALY, indicating that RTX treatment is approximately two times more cost-effective compared to TAC. Conclusion: The current analysis indicates that despite the expensive unit price of RTX, it remains a cost-effective treatment option for MN compared to TAC. CI - Copyright (c) 2024 Zeng, Chen, Xiang, Zeng, Zhou, Tan, Liu and Chen. FAU - Zeng, Li AU - Zeng L AD - Department of Nephrology, The Second Xiangya Hospital of Central South University, Changsha, China. AD - Hunan Key Laboratory of Kidney Disease and Blood Purification, The Second Xiangya Hospital of Central South University, Changsha, China. FAU - Chen, Huihui AU - Chen H AD - Clinical Immunology Research Center of Central South University, Changsha, China. AD - Department of Ophthalmology, The Second Xiangya Hospital of Central South University, Changsha, China. FAU - Xiang, Heng AU - Xiang H AD - Department of Pharmacy, The Second Xiangya Hospital of Central South University, Changsha, China. FAU - Zeng, Mengru AU - Zeng M AD - Department of Nephrology, The Second Xiangya Hospital of Central South University, Changsha, China. AD - Hunan Key Laboratory of Kidney Disease and Blood Purification, The Second Xiangya Hospital of Central South University, Changsha, China. FAU - Zhou, Mi AU - Zhou M AD - Department of Nephrology, The Second Xiangya Hospital of Central South University, Changsha, China. AD - Hunan Key Laboratory of Kidney Disease and Blood Purification, The Second Xiangya Hospital of Central South University, Changsha, China. FAU - Tan, Chongqing AU - Tan C AD - Department of Pharmacy, The Second Xiangya Hospital of Central South University, Changsha, China. FAU - Liu, Hong AU - Liu H AD - Department of Nephrology, The Second Xiangya Hospital of Central South University, Changsha, China. AD - Hunan Key Laboratory of Kidney Disease and Blood Purification, The Second Xiangya Hospital of Central South University, Changsha, China. FAU - Chen, Guochun AU - Chen G AD - Department of Nephrology, The Second Xiangya Hospital of Central South University, Changsha, China. AD - Hunan Key Laboratory of Kidney Disease and Blood Purification, The Second Xiangya Hospital of Central South University, Changsha, China. AD - Clinical Immunology Research Center of Central South University, Changsha, China. LA - eng PT - Journal Article DEP - 20240108 PL - Switzerland TA - Front Pharmacol JT - Frontiers in pharmacology JID - 101548923 PMC - PMC10800561 OTO - NOTNLM OT - Markov model OT - membranous nephropathy OT - pharmacoeconomic analysis OT - rituximab OT - tacrolimus COIS- The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2024/01/23 12:44 MHDA- 2024/01/23 12:45 PMCR- 2024/01/08 CRDT- 2024/01/23 10:24 PHST- 2023/10/08 00:00 [received] PHST- 2023/12/20 00:00 [accepted] PHST- 2024/01/23 12:45 [medline] PHST- 2024/01/23 12:44 [pubmed] PHST- 2024/01/23 10:24 [entrez] PHST- 2024/01/08 00:00 [pmc-release] AID - 1309930 [pii] AID - 10.3389/fphar.2023.1309930 [doi] PST - epublish SO - Front Pharmacol. 2024 Jan 8;14:1309930. doi: 10.3389/fphar.2023.1309930. eCollection 2023.