PRO55 COST-EFFECTIVENESS ANALYSIS OF PIRFENIDONE TABLETS COMPARED WITH NINTEDANIB FOR IDIOPATHIC PULMONARY FIBROSIS (IPF) TREATMENT IN TURKEY

Abstract

In Turkey, pirfenidone is approved for mild-moderate IPF, an irreversible lung disease. Most IPF patients are more than 50-years old and face age-related comorbidities. In order to reach the recommended daily dose (2403 mg/day), patients need to take 9 (267 mg) pirfenidone capsules per day. The new formulation (801 mg) allows patients to take 3 tablets per day to reach this dose. Hence, pirfenidone tablets have the potential to increase patient adherence to treatment. The objective of this study is to evaluate the cost-effectiveness of pirfenidone tablets compared to best supportive care (BSC) from the perspective of SSI (Social Security Institute - national payer). A Markov model using parametric survival model with four health states: progression-free, progressed, lung transplantation and death, is used. Two cohorts (pirfenidone or BSC) are introduced in the model starting from the progression-free state. Patients either stayed in health state or moved to the next, based on their risk of disease progression. Cycles in the model last for 3 months. Each health state is associated with a level of cost and utility. 1.000 Monte-Carlo simulations are conducted. Discount rate used is 3,5%. The model findings are validated with Deterministic Univariate Sensitivity Analysis and Probabilistic Sensitivity Analysis (PSA). The incremental cost of treatment with pirfenidone tablets is found to be 159.157 TRY and incremental QALY is 2,021 years. ICER is 78.745 TRY. PSA results demonstrate that when compared with BSC, pirfenidone tablets’ ICER is 77.711 TRY. Pirfenidone tablets are found to be a cost-effective option compared to BSC in Turkey. The results are consistent within the sensitivity analyses.