Cost analysis of the impact of caplacizumab in the treatment of acquired thrombotic thrombocytopenic purpura from a US hospital perspective. (1st January 2021)

• Record Type: Journal Article
• Authors: Pollissard, Laurence; Leinwand, Brian I.; Fournier, Marie; Pham, Huy P.
• Is Part Of: Journal of medical economics. Volume 24:Number 1(2021)
• Page Start: 1178
• Page End: 1184
• Publication Date: 2021-01-01
• Subjects: Cost analysis -- costs -- acquired thrombotic thrombocytopenic purpura -- budget impact -- healthcare service use -- caplacizumab; C55 - Large Data Sets -- Modeling and Analysis < C5 - Econometric Modeling < C - Mathematical and Quantitative Methods -- I11 - Analysis of Health Care Markets < I1 - Health < I – Health -- Education -- Welfare; Medical care -- Cost control -- Periodicals; Medical economics -- Periodicals; 362.10941
• DOI: 10.1080/13696998.2021.1992413
• Languages: English
• ISSNs: 1369-6998

Abstract

Abstract: Aim: This study aimed to model the financial impact of caplacizumab with therapeutic plasma exchange (TPE) + immunosuppression for patients experiencing an acute acquired thrombotic thrombocytopenic purpura (aTTP) episode versus TPE + immunosuppression, from a US hospital&#39;s perspective. Methods and materials: We developed an economic model to estimate the impact of caplacizumab on a US hospital&#39;s budget. Cost offsets from caplacizumab utilization targeted inpatient general ward days, intensive care unit (ICU) days, and TPE utilization. Costs and event probabilities were estimated from primary data analyses of the phase 3 HERCULES trial and peer-reviewed literature or other public sources. Plan reimbursement was obtained from 2019 Medicare Fee Schedules and adjusted to represent reimbursement from different US payers. Cost of ICU and general ward utilization were estimated from Medicare Provider Analysis and Review data analyses capturing hospital discharges. Results: The model results indicate that caplacizumab leads to hospitalization cost savings of over $8, 000 ($23, 148 versus $14, 904) along with TPE cost savings of over $14, 000 ($37, 150 versus $23, 033) per patient. When the cost of caplacizumab and plan reimbursement are incorporated into the results, the per-patient cost of TPE + immunosuppression is $23, 120 versus $70, 068 for caplacizumab with TPE + immunosuppression, an incremental cost of $46, 948. The model was robust to several scenario analyses; however, when limited to Medicare fee-for-service (FFS), the incremental cost of caplacizumab per patient was reduced to $4, 852 due to add-on payments. Conclusions: Caplacizumab with TPE + immunosuppression is associated with an increase in costs; however, the increase is nominal among payers who provide an add-on payment consistent with that of Medicare FFS.