Budget impact analysis on the Italian healthcare system of roxadustat for the treatment of anemia due to chronic kidney disease

Authors

  • Chiara Bini Centre for Economics and International Studies-Economic Evaluation and Health Technology Assessment, Faculty of Economics, University of Rome “Tor Vergata”, via Columbia 2, 00133 Roma - Italy
  • Andrea Marcellusi Centre for Economics and International Studies-Economic Evaluation and Health Technology Assessment, Faculty of Economics, University of Rome “Tor Vergata”, via Columbia 2, 00133 Roma - Italy https://orcid.org/0000-0002-3974-3798
  • Paolo Di Rienzo Astellas Pharma SpA, Via Don Luigi Sturzo 43, Milano - Italy https://orcid.org/0000-0001-8979-3980
  • Lucia Del Vecchio U.O. Nefrologia e Dialisi, ASST Lariana, Via Ravona 20, 22042 San Fermo Della Battaglia (Como) - Italy

DOI:

https://doi.org/10.33393/grhta.2024.3062

Keywords:

Anaemia, Chronic kidney disease, Economic evaluation, Roxadustat

Abstract

Objective: The aim of this study was to evaluate the economic consequences of the introduction of roxadustat on the market as treatment for chronic kidney disease (CKD)-related anaemia in Italy.

Method: A budget impact model was developed to assess the economic impact of the introduction of roxadustat for the management of patient with CKD-related anaemia. The analysis was conducted considering National Health Service (NHS) perspective and three years’ time horizon. Eligible population for the treatment with roxadustat was estimated through published literature and clinicians’ support. Direct healthcare costs included drug acquisition (list prices for base case) and administration costs, monitoring costs, cost per blood transfusion, costs related to the management of adverse events and dialysis costs.

Results: The model estimated a three years expenditure associated with the management of patients with CKD-related incident anaemia in Italy of about € 260 and € 44.6 million for non-dialysis dependent (NDD) and dialysis-dependent (DD) patients respectively. The introduction of roxadustat on the market could generate a reduction in the expenditure related to the iron supplementation both for NDD and for DD patients (−€ 397,305 and −€ 50,135 over three years of the analysis, respectively) and a reduction in the pharmaceutical expenditure for NDD patients (−€ 2.3 million, −€ 7.5 million and −€ 13 million at first, second and third year of the analysis). Overall, the introduction of roxadustat could generate a saving for NHS approximately equal to € 2.3, € 7.5 and € 13 million at first, second and third year of the analysis.

Conclusion: The introduction of roxadustat could generate a reduction in the expenditure for the management of patients with CKD anaemia. A scenario analysis which used tender prices for ESAs and hypothesis of confidential discount for roxadustat showed that the saving for NHS will be kept if roxadustat’s discount is greater than 60.3%.

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Published

2024-09-10

How to Cite

Bini, C., Marcellusi, A., Di Rienzo, P., & Del Vecchio, L. (2024). Budget impact analysis on the Italian healthcare system of roxadustat for the treatment of anemia due to chronic kidney disease. Global and Regional Health Technology Assessment, 11(1), 175–190. https://doi.org/10.33393/grhta.2024.3062

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Original Research Articles

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Received 2024-03-07
Accepted 2024-07-01
Published 2024-09-10

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