PSY93 - A Cost-Effectiveness Analysis of Pasireotide Long-Acting Compared To Continued Use of A First-Line Somatostatin Antagonist For The Treatment of Acromegaly In Sweden

Abstract

Acromegaly is in adults characterized by an acquired progressive somatic disfigurement, resulting from an excessive production of growth hormone (GH). The primary goal when treating acromegaly is biochemical control; normalized GH and insulin growth factor 1 (IGF-1) serum levels. Pasireotide is a somatostatin antagonist (SSA), offering a novel treatment option for patients who do not achieve biochemical control on first-line SSAs. This analysis explores the cost-effectiveness of pasireotide long-acting compared to the continued use of a first-line SSA. A previously developed model was modified to enable the analysis in the Swedish setting. The Markov model consisted of five health states to capture the disease progression and management of acromegaly. In each cycle of the model patients also face a risk of dying. The health states had different risk of death, costs, and QALY-weights associated with them. Inputs to the analysis were sourced from literature and the pivotal clinical trial for pasireotide. Costs and health-benefits were discounted three percent per annum. The analysis was performed from the societal perspective with a life-long time horizon. The estimated incremental cost per quality-adjusted life-year was SEK 668 116 compared to the continued use of first-line SSAs. Deterministic sensitivity analysis indicates the result to be robust to changes to key parameters used in the analysis. With an ICER of approximately SEK 670 000 from the societal perspective, the use of pasireotide to treat acromegaly may, in light of the severity and rareness of the disease, be considered a cost-effective alternative to the continued use of first-line SSA in Sweden.