Differences in hospitalization-related costs with oral PAH therapies

Treatment with selexipag could save payers costs over 2 years compared with oral treprostinil, according to results of a comparative cost model reported at the Academy of Managed Care Pharmacy virtual meeting.

Researchers used a comparative cost model to estimate cost differences associated with treating patients with pulmonary arterial hypertension using two different oral agents that target the prostacyclin pathway. The model estimated total costs, which included drug and hospitalization costs, to a U.S. health care payer of using selexipag (Uptravi, Actelion/Johnson & Johnson) vs. oral treprostinil (Orenitram, United Therapeutics).

The researchers focused on a 2-year horizon to fully capture titration followed by maintenance duration. They then analyzed hospitalization rates among patients treated with selexipag and oral treprostinil based on a publication of real-world data from the Optum Clinformatics Data Mart. The researchers reported results from a base case for a hypothetical U.S. commercial plan with 78 patients with PAH.

“In doing so, our analysis found that PAH-related hospital admissions were reduced by 46% when patients were treated with selexipag compared to oral treprostinil. Additionally, our cost calculator that incorporated the real-world hospital reduction estimates showed that a U.S. health plan with 1 million members would realize approximately 22% in total cost savings when PAH patients were treated with selexipag in comparison to oral treprostinil,” Sumeet Panjabi, senior director of Real World Value & Evidence at Janssen Pharmaceuticals, told Healio.

In the comparative cost model, 2-year total costs with selexipag were $48,281,212 with 98 pulmonary hypertension-related admissions compared with $55,399,134 and 161 pulmonary hypertension-related admissions with oral treprostinil, according to the abstract. Use of selexipag was associated with a total cost saving of approximately $12 million over 2 years, according to the results.

Selexipag, compared with oral treprostinil, was associated with 39% lower total pulmonary hypertension-related admissions, according to the abstract. At 2 years, the number needed to treat to avoid one hospitalization was 1.23 with selexipag, according to the results.

When the researchers analyzed use of selexipag vs. oral treprostinil over 1 year, selexipag led to cost savings of 4.3%, according to the abstract.

The impetus behind the current analysis was a real-world analysis of hospitalization data in patients with PAH published in Pulmonary Circulation in November 2020, according to Panjabi. In that analysis, use of selexipag was associated with a 47% lower risk for pulmonary hypertension-related hospitalization and a 46% lower rate of pulmonary hypertension-related hospitalization compared with use of oral treprostinil, he said.

“We know the considerable economic impact PAH-related health care costs can potentially have on both patients and health institutions. The data from our retrospective claims analysis demonstrated how treatments for PAH that are beneficial to patients can have a positive benefit for health systems at large, even in a span of just 2 years, which is considered a relatively short timeframe for health systems to see an impact,” Panjabi said. “Data from real-world analyses, coupled with clinical trial data along with [health care personnel] expertise, could be an incredibly valuable addition to help inform treatment strategies and spark behavioral change when treating individuals with PAH.”

Reference:

McConnell JW, et al. Pulmonary Circ. 2021;doi:10.1177/2045894020911831.