Further study needed on cost-effectiveness of teprotumumab for thyroid eye disease
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CHICAGO — Commercial insurer payments for teprotumumab vary dramatically, with cost influencing access to care and cost-effectiveness, according to a study presented at the ASOPRS Fall Scientific Symposium.
Even though Tepezza (teprotumumab, Horizon Therapeutics) was found in the study to have the highest recorded measure of Graves’ orbitopathy quality of life (GO-QOL) compared with other thyroid eye disease (TED) treatments, it was also associated with the highest cost per unit of that change (GO-QOL), according to Tracy J. Lu, MD, of Stanford University School of Medicine.
“Our analysis provides a framework to think about TED treatment costs critically,” Lu said.
In the study, cost of treatment was determined using a comprehensive list of billing codes for treatments and procedures, including teprotumumab, orbital radiotherapy (ORT), rituximab, intravenous methylprednisolone (IVMP) and IVMP plus mycophenolate mofetil (MMF), and those costs were related to changes in quality of life in patients with active moderate to severe TED.
Across the U.S., commercial costs of teprotumumab ranged from $431,000 to $981,000, with a median cost of $823,000.
Teprotumumab had the highest mean GO-QOL score compared with the other treatments; however, it also had the highest cost per unit of that change at $48,400/GO-QOL, followed by rituximab at $5,330/GO-QOL, ORT at $3,670/GO-QOL, and IVMP and IVMP plus MMF at $980/GO-QOL and $1,780/GO-QOL, respectively.
“Future studies that can correlate the GO-QOL score with the standardized health utility metric, such as the quality-adjusted life-year, would also facilitate a standardized cost-effectiveness analysis,” Lu said. “These types of cost-effectiveness analyses can then inform treatment algorithms. In turn, better treatment algorithms that are based on individual patient characteristics can improve cost-effectiveness.”
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Lu TJ, et al. Comparison of treatment cost and quality-of-life impact of thyroid eye disease therapies. Presented at: ASOPRS Fall Scientific Symposium; Sept. 29-30, 2022; Chicago.
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