PSY11 Belimumab in Patients with Systemic LUPUS Erythematosus in Kazakhstan: A Cost-Effectiveness Analysis

Abstract

To estimate the cost-effectiveness of belimumab in patients with active, autobody-positive systemic lupus erythematosus (SLE) from the healthcare system perspective of Kazakhstan. The analysis compared current standard of care therapy (SoC) versus SoC plus belimumab (400 mg and 120 mg vials). A microsimulation model with yearly cycles and a lifetime horizon was adapted to the Kazakhstan setting. Data from the BLISS studies was used to inform the model’s clinical and utility parameters. Direct costs were applied using national reference prices and Diagnosis-Related Group tariffs. Probabilistic sensitivity analysis (PSA) was conducted to explore the effect of parameter uncertainty. In the base case scenario, SoC therapy resulted in costs of 16.91 million Kazakhstani tenge (T) (equivalent to 124 589 international dollars (Int$) using the 2019 PPP conversion factor) and 15.14 quality-adjusted life years (QALY), while the corresponding results for SoC plus belimumab amounted to 15.67 QALYs and 28.55 million T (210 390 Int$) for the 400 mg vial or 28.64 million T (211 042 Int$) for the 120 mg vial. The resulting incremental cost-utility ratio was 21.86 million T (161 044 Int$) per QALY gained for the 400 mg vial and 22.02 million T (162267 Int$) for the 200 mg vial. PSA results indicated that the SoC plus belimumab strategy was cost-effective in approximately one-third of iterations at the willingness-to-pay threshold constructed as 3 times national GDP per capita (10.15 million T). In the context of the healthcare system of Kazakhstan, the analysis suggests that the addition of belimumab may potentially improve the outcomes for patients with SLE. Due to the model assumptions and complexity, the results should be interpreted with caution. Additional country-specific data may be needed to more accurately reflect the potential outcomes in patients with SLE in Kazakhstan and the economic impact of belimumab.