PRO33 Ravulizumab Reduces Productivity Losses Versus Eculizumab for Treating Atypical Hemolytic Uremic Syndrome: A 'cost Consequence' Analysis in 4 Countries

Abstract

Ravulizumab, a long-acting complement C5 inhibitor for the treatment of atypical hemolytic uremic syndrome (aHUS), was engineered from eculizumab to reduce dosing frequency and improve patient outcomes. This multinational study compared the potential impact on productivity of different ravulizumab and eculizumab treatment regimens. A ‘cost consequence calculator’ was used to compare hours spent in treatment and resultant productivity losses among patients with aHUS treated with ravulizumab (10 mg/mL and 100 mg/mL) or eculizumab, in clinic or at home, in Germany, Italy, the UK and the USA. Body weight was used to determine the number and dose of infusions. In a hypothetical population of 100 patients treated for one year, spread equally across four body weight categories (≥10–20 kg; >20–40 kg; >40–60 kg and >60–100 kg), lost productivity costs were calculated as the product of the aggregate country-specific durations of therapy (medication preparation time, treatment duration, recovery and travel time) and a normalized baseline wage of US$20/hour. It was assumed that all infants/children and 10–20% of adolescents/adults were accompanied by a caregiver during treatment. In all four countries, ravulizumab was associated with a lower aggregate duration of therapy than eculizumab (3,558–6,664 hours [ravulizumab 100 mg/mL] versus 13,873–21,870 hours [eculizumab]), with the lowest duration of therapy associated with 100 mg/mL ravulizumab administered at home. For infusions administered at home, ravulizumab 100 mg/mL reduced the impact on productivity losses by 73% in Germany (reduction of $202,594) and 74% in the UK and USA (reductions of $206,517 and $208,795, respectively), compared with eculizumab. In Italy, where infusions are only available in clinic, ravulizumab 100 mg/mL reduced the impact on productivity losses by 70% (reductions of $260,790). For patients with aHUS, ravulizumab substantially reduces aggregate duration of therapy and lowers productivity losses compared with eculizumab across multiple countries.