![Sample our Politics & International Relations journals, sign in here to start your FREE access for 14 days]({"type":"image" , "src" : "/sda/5947/TOC-Subject-Sample-2021-Politics-International-Relations.jpg"})
ABSTRACT
Objective: To update the health economic evaluation of pirfenidone in the treatment of idiopathic pulmonary fibrosis (IPF) compared to all available alternatives strategies (Best supportive care – BSC and nintedanib), based on a cost-utility model previously validated by the CEESP’s (French Committee for Economic Evaluation) in 2014.
Methods: A standard Markov cohort model, adapted to French methodology guidelines, was used to simulate the therapeutic management and the course of IPF patients (including potential adverse events) using the collective perspective. Cost-effectiveness was evaluated regarding life years (LY); quality-adjusted life-years (QALY); average cumulative costs; the incremental cost-effectiveness ratio (ICER) expressed in cost per QALY gained. Data were retrieved from trials, meta-analysis, literature, health insurance and hospitalisation databases, and national tariffs.
Results: Over 15 years, total costs accumulated in the pirfenidone strategy were estimated at €99,477 per patient, €104,610 in nintedanib, and €14,177 in Best Supportive Care (BSC). The total number of QALYs accumulated equalled 5.20 (6.91 LYs), 4.52 (5.98 LYs), and 3.79 (4.98 LYs), respectively. Pirfenidone was estimated to be dominant over nintedanib with incremental costs of -€5,133 and 0.67 more QALYs accumulated. Incremental cost versus BSC was €85,300 and 1,404 QALY gained. The cost-effectiveness ratio was estimated at 60,738€/QALY when compared to BSC.
Conclusion: Pirfenidone is likely to be a cost–effective strategy compared to BSC and seems more efficient and less costly compared to nintedanib for the treatment of patients with IPF in France.
Authors contribution
EC, OC prepared and adapted the economic model. EC, OC prepare the first draft of the manuscript. MB, EC, OC validated the model structure and assumption. Data collection and results interpretation were performed by MB, EC, OC, RC and AP. VC validated data interpretation and medical content. All authors provided critical feedback on the manuscript and have approved the final version.
Disclosure statement
This work was supported by Roche and conducted by Creativ-Ceutical. VC declare consultancy/advisory roles for ROCHE SAS. VC also declares grant/research funding from Boehringer Ingelheim and Roche, and also a consultancy/advisory role for Actelion, Bayer, Boehringer Ingelheim, Biogen, Gilead, GSK, MSD, Novartis, Roche, Sanofi, Celgene, Promedior, and Galapagos NV.
Ethical approval
This article does not contain any studies with human participants or animals performed by any of the authors.