Health Care Resource Utilization and Costs Among Patients with Paroxysmal Nocturnal Hemoglobinuria Initiating Eculizumab and Ravulizumab: A U.S. Claims Analysis
Author(s)
Lin CW, Wang R, Tzeng E
Genentech Inc., South San Francisco, CA, USA
Presentation Documents
OBJECTIVES: This retrospective cohort study aims to describe health care resource utilization (HCRU) and costs for treatment-naive paroxysmal nocturnal hemoglobinuria (PNH) patients initiating eculizumab or ravulizumab in the US.
METHODS: Using the IQVIA PharMetricsⓇ Plus claims database (6/21/2018-3/31/2023), eligible adults (≥ 18 years) with ≥ 2 claims of eculizumab or ravulizumab were included. The index date was the earliest drug claim, with a 6-month clean period. Continuous medical and pharmacy coverage for 6 months before and 12 months after index were required. Patients with a non-PNH FDA-approved diagnosis for eculizumab or ravulizumab, or received an investigational treatment were excluded. HCRU and costs during 12-month post-index were summarized, with a subgroup analysis for patients with aplastic anemia or myelodysplastic syndromes (AA/MDS) diagnoses pre-index.
RESULTS: A total of 75 patients were analyzed (27 eculizumab; 48 ravulizumab).
HCRU was substantial for both eculizumab (52% and 56% had inpatient and emergency department [ED] visits) and ravulizumab patients (12% and 31% had inpatient and ED visits). All patients had hospital outpatient visits, averaging 64 and 24 visits for eculizumab and ravulizumab patients, respectively; 48% eculizumab and 35% ravulizumab patients had home care visits, averaging 12 and 4 visits, respectively. Mean total cost of care for 12-month post-initiation was $738,695 (SD: $374,577) for eculizumab and $670,010 (SD: $317,524) for ravulizumab . Drug costs were the primary cost driver, while hospital outpatient represented 44% ($113,357) and 43% ($29,465) of non-drug costs for eculizumab and ravulizumab, respectively. The AA/MDS subgroup, constituting 43% of the study cohort (12 eculizumab; 20 ravulizumab), incurred higher total costs with increased inpatient and ED utilization (eculizumab: 67% and 75%; ravulizumab: 20% and 50%).CONCLUSIONS: PNH patients initiating eculizumab or ravulizumab experienced extensive HCRU burden with frequent hospital outpatient visits, beyond high drug costs.
Conference/Value in Health Info
Value in Health, Volume 27, Issue 6, S1 (June 2024)
Code
EE326
Topic
Economic Evaluation
Disease
Drugs, Rare & Orphan Diseases