Beur schreef op 24 augustus 2018 12:32:
[...]Waarom hoor ik daar niemand over? Check 4.3 Results (blz 43) van het ICER-rapport en met name Tabel 4.13 (blz 45) en tabel 4.14 (blz 46).
"The base-case results are shown in Tables 4.13 and 4.14. The average total lifetime direct costs for no prophylaxis was $10,560,000. This included $9,725,000 in on-demand drug costs for acute treatment and $830,000 in other acute treatment costs (including administration costs, ED visits, hospitalizations, and emergency procedures for those with laryngeal attacks). The average lifetime direct costs for patients receiving prophylaxis ranged from $9,810,000 for patients receiving Haegarda to $23,800,000 for patients receiving Ruconest. Prophylactic drug costs ranged from $8,282,000 (Haegarda) to $19,900,000 (Ruconest). On-demand drug costs for acute treatment ranged from $1,274,000 for patients receiving lanadelumab to $4,814,000 for patients receiving Cinryze), and other acute treatment costs ranged from $109,000 for patients receiving lanadelumab to $412,000 for patients receiving Cinryze."
Conclusion:
"We found that, in general, prophylaxis against acute attacks in patients with HAE 1/2 improves health outcomes in comparison to no prophylaxis. Based on our analyses we predict that Lanadelumab and C1 Inhibitors for Long-Term Prophylaxis of HAE Return to TOC incremental cost-effectiveness ratios for all prophylactic therapies would decrease (i.e., become more favorable) with increasing baseline attack frequency. Based on currently available price data, Haegarda was dominant over no prophylaxis; while Cinryze and Ruconest were unlikely to be costeffective at the same cost per QALY gained threshold"