Budget Impact Analysis for the Use of Sodium Phenylacetate and Sodium Benzoate in the Treatment of Acute Hyperammonemia: Experience in a Saudi Setting

Author(s)

Alshahrani A1, Alqahtani S2, Alhawashi ST3, Al-Nasser MS4, Zaitoun M4
1Armed Forces Hospitals Southern Region, Khamis Mushait , 14, Saudi Arabia, 2Jazan University, Jazan, Saudi Arabia, 3Security forces hospital program, Riyadh, Saudi Arabia, 4Pharmaceutical care administration, Armed Forces Hospitals Southern Region, Khamis Mushayt, Saudi Arabia

Objectives: Sodium phenylacetate/Sodium benzoate injection combination is an orphan drug indicated as an adjunct therapy in treating acute Hyperammonemia and associated encephalopathy in patients with urea cycle enzyme deficiencies. There is a lack of economic data on its use in the pediatric population, particularly in Saudi Arabia. This analysis aims to assess the budget impact of Sodium phenylacetate and Sodium benzoate injection combination in treating acute Hyperammonemia and associated encephalopathy in patients with urea cycle enzyme deficiencies compared to hemodialysis in the pediatric population.

METHODS: Utilizing the cost estimates from the armed forces hospitals southern region purchasing data, a budget impact model was developed using Microsoft Excel® to compare the costs associated with two scenarios: the 'formulary without Sodium phenylacetate/Sodium benzoate' and the 'formulary with Sodium phenylacetate/Sodium benzoate'.

Results: Over five years after the addition of the drug to the hospital formulary and from the health care payer perspective "pharmacy budget", we estimated the population eligible for treatment to be 16 patients, with an estimated uptake rate of 50 % in year 1 and 100% in year 5. The gross impact on the pharmacy budget was estimated to be SAR 82,000 in year one and SAR 660,000 in year five. Hemodialysis was assumed to be an alternative; the net of two procedures budget impact is expected to be SAR 3,360 in year one and SAR 67200 in year five.

Conclusions: For the analysis population, the use of Sodium phenylacetate/Sodium benzoate is associated with substantially increased costs. Considering the analysis findings, lack of robust evidence for survival benefits, and limited treatment options, Sodium phenylacetate/Sodium benzoate may be occasionally considered in cases not responsive or eligible for hemodialysis. Further clinical studies on this medication use are recommended.

Conference/Value in Health Info

2022-05, ISPOR 2022, Washington, DC, USA

Value in Health, Volume 25, Issue 6, S1 (June 2022)

Code

EE268

Topic

Economic Evaluation

Topic Subcategory

Budget Impact Analysis

Disease

Drugs, Pediatrics

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