Cost-Effectiveness Analysis of Selexipag Versus Inhaled Iloprost In The Treatment of Pulmonary Arterial Hypertension (PAH) In Sweden

Abstract

moderate to severe asthma. Methods: Two literature reviews were conducted to retrieve economic evaluations (1) on moderate to severe asthma treatment and (2) on PM in asthma to identify key parameters for the development of the decision tree. The economic impact of PM testing to guide the choice of treatment for uncontrolled moderate to severe asthma can be assessed from a provincial Ministry of Health (MoH) or a societal perspective over a 1-year period. Asthma exacerbations were the main efficacy parameter considered and costs included were treatments, resource utilization, administration, follow-up and productivity loss. Values were extracted from literature and governmental publications. The model was tested in an applied context, using the blood type-E immunoglobulin (IgE) assay to guide treatment with omalizumab compared with no testing (omalizumab for all). Results: When tested, total cost reduction was -$8,811 and -$9,225 from a MoH and a societal perspective respectively for a total QALY gain of 0.06 per patient, which lead to a dominant strategy for IgE testing compared to no testing. According to deterministic analysis results, IgE testing remains a dominant strategy over no testing in all scenarios tested. However, parameters with the greatest impact on base-case ICURs were the prevalence of allergic asthma and the cost of omalizumab. ConClusions: The global economic model can help estimating on a similar basis the economic impact of several technologies using PM testing to guide the treatment of uncontrolled moderate to severe asthma.

Cost-effectiveness analysis of selexipag for the combined treatment of pulmonary arterial hypertension

“…Four studies on the pharmacoeconomics of selexipag have been conducted in Canada ( Pharmacoeconomic Review Report: Selexipag Uptravi, 2017 ), Sweden ( Wlodarczyk et al, 2016 ), and Greece ( Solakidi et al, 2017a ; 2017b ). The last three studies have not been able to obtain the full text or specify research details.…”

“…A study from Sweden has compared the cost-effectiveness of sequential administration of selexipag and inhaled iloprost for PAH patients who had received ERA and PDE5i from the societal perspective. Selexipag was more cost-effective than inhaled iloprost (ICER 37,350 SEK per QALY) ( Wlodarczyk et al, 2016 ). A Greece study has compared the cost-effectiveness of sequential administration of selexipag and subcutaneous treprostinil in PAH patients with FC III who had received ERA and PDE5i but had insufficient efficacy from a Greek payer perspective.…”

“…Follow-up examination items included WHO functional class, blood routine, blood biochemistry, arterial oxygen saturation, brain natriuretic peptide (BNP) or N-terminal (NT)-proBNP, 6-min walk test (6MWT), echocardiography, right heart catheterization (RHC), etc. ( Wlodarczyk et al, 2016 ). Outpatient and follow-up examination fees were calculated using the median price of medical services published by the Human Resources and Social Security Bureaus of Shenyang ( Health Commission of Shenyang, 2022 ), Beijing ( Beijing Municipal Medical Insurance Bureau, 2021 ), Chengdu ( Chengdu Healthcare Security Administration and Chengdu Municipal Health Commission, 2020 ), Shanghai ( Shanghai Municipal Development et al, 2017 ), and Changsha ( Changsha Healthcare Security Administration, 2020 ), which represent the geographical area and economic development in China ( Liu et al, 2022 ).…”

“…Follow-up examination items included WHO functional class, blood routine, blood biochemistry, arterial oxygen saturation, brain natriuretic peptide (BNP) or N-terminal (NT)-proBNP, 6-min walk test (6MWT), echocardiography, right heart catheterization (RHC), etc. (Wlodarczyk et al, 2016). Outpatient and follow-up examination fees were calculated using the median price of medical services published by the Human Resources and Social Security (Liu et al, 2022).…”