University of Twente Student Theses
The budget impact of Belimumab SC compared to the standard of care in adult patients with antibody-positive systematic lupus erythematosus in the Dutch setting
Goossink, S.F. (2023) The budget impact of Belimumab SC compared to the standard of care in adult patients with antibody-positive systematic lupus erythematosus in the Dutch setting.
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| Abstract: | Objective This study evaluates the budget impact and the direct and indirect costs of using Belimumab subcutaneous (SC) for systemic lupus erythematosus (SLE) patients in the Dutch setting. Methods The budget impact model of Belimumab SC was developed from a Dutch societal perspective with a time horizon of three years (2023 – 2025). The budget impact of Belimumab SC was calculated as the cost difference between the two scenarios: the future scenario (with Belimumab SC) and the current scenario (without Belimumab SC). The eligible prevalence population could be defined as adult, antibody-positive SLE patients with moderate to severe active disease activity in the Netherlands (n = 937). The included direct costs were the pharmacological costs, administration costs, adverse events costs, and management of flares costs. Besides, the included indirect costs were the costs of organ damage, dialysis or transplantations due to End Stage Kidney Disease (ESKD), and productivity loss or absenteeism. The data from the BLISS-SC trial, a phase 3, multicenter, randomized, double-blind, placebo-controlled, 52-week study to evaluate the efficacy and safety of Belimumab SC in adult subjects with active SLE, formed the basis for the budget impact model of Belimumab SC. In addition, the model was informed by published peer-reviewed literature, market research data, and official publications. Sensitivity and scenario analyses were performed. Results For the pharmacological cost factor, the budget impact of Belimumab SC over three years was approximately €9.6 million. In addition, the budget impact of Belimumab SC for managing flares was about -€1.9 million over three years. Furthermore, the budget impact for adverse events was approximately -€800,000 over three years. The budget impact for productivity loss or absenteeism was about -€2.6 million over three years. The second last factor, dialysis or transplantation due to ESKD, gave a budget impact of approximately -€450,000 over three years. Finally, the irreversible organ damage factor gave a budget impact of around -€110,000 over three years. Based on these cost factors used in the budget impact model, the total budget impact of Belimumab SC resulted in an expenditure of approximately €3.7 million over three years in the Dutch setting. Conclusion The budget impact model developed in this study indicated that Belimumab SC in addition to the standard of care (BSoC), resulted in increased expenditure compared to the patients treated with the standard of care (SoC) in the Dutch setting over three years. The budget impact analysis provides decision-makers on a national level with an overview of the direct and indirect costs, allowing better management of the hospital budgets regarding expensive intramural drugs. For this study, we used assumptions and values that were, to the best of our knowledge, the most suitable in the Dutch setting to assess the future impact of Belimumab SC. This data emphasizes the importance of controlling and monitoring flares, loss of productivity, and pharmacological costs, which are the leading causes of rising societal costs. Future improvements can be made using a retrospective cohort study in the Dutch setting to demonstrate the impact of BSoC on SLE patients. Keywords Systemic lupus erythematosus, Belimumab, Budget Impact Model, Dutch setting, Flares |
| Item Type: | Essay (Master) |
| Clients: | GlaxoSmithKline, Amersfoort, Netherlands |
| Faculty: | TNW: Science and Technology |
| Subject: | 44 medicine |
| Programme: | Health Sciences MSc (66851) |
| Link to this item: | https://purl.utwente.nl/essays/96213 |
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