RationaleTreatment options approved in the United States (US) for on-demand use for type I or II attacks of hereditary angioedema (HAE) provide similar efficacy. They differ, however, by the doses administered per patient and price per administration, weighted in part by the need for re-dosing. The differential costs to resolve symptoms of an HAE attack have not been reported previously.MethodsA cost minimization analysis was used to compare the differences in processes required to achieve resolution of HAE attacks with Berinert® (CSL Behring, Marburg, Germany), Firazyr®(Shire, Lexington, US) and Kalbitor™ (Dyax Corp., Burlington, US). The differential costs were compared indirectly using the current, publically available prices of Berinert 20 IU/kg (average selling price), Firazyr 30 mg (wholesale acquisition cost +6%) and Kalbitor 30 mg (average selling price). The results were weighted by typical re-dosing frequencies.ResultsEstimates for re-dosing frequencies with approved HAE treatments were based on clinical trial data: 1% with Berinert, 7% with Firazyr, and 20% with Kalbitor. Since Berinert is dosed based on weight, its dosing in this analysis ranged from 2 to 5 vials (500 IU each) for patients weighing 50 to 150 kg. Per attack, Berinert was estimated to save the payers $79.29 to $4,659 with respect to Firazyr and $2,628 to $7,208 with respect to Kalbitor.ConclusionsThe indirect comparison of on-demand treatment costs for HAE attacks estimated cost savings to the payer from use of Berinert vs. either Firazyr or Kalbitor for patients up to 330 pounds body weight. RationaleTreatment options approved in the United States (US) for on-demand use for type I or II attacks of hereditary angioedema (HAE) provide similar efficacy. They differ, however, by the doses administered per patient and price per administration, weighted in part by the need for re-dosing. The differential costs to resolve symptoms of an HAE attack have not been reported previously. Treatment options approved in the United States (US) for on-demand use for type I or II attacks of hereditary angioedema (HAE) provide similar efficacy. They differ, however, by the doses administered per patient and price per administration, weighted in part by the need for re-dosing. The differential costs to resolve symptoms of an HAE attack have not been reported previously. MethodsA cost minimization analysis was used to compare the differences in processes required to achieve resolution of HAE attacks with Berinert® (CSL Behring, Marburg, Germany), Firazyr®(Shire, Lexington, US) and Kalbitor™ (Dyax Corp., Burlington, US). The differential costs were compared indirectly using the current, publically available prices of Berinert 20 IU/kg (average selling price), Firazyr 30 mg (wholesale acquisition cost +6%) and Kalbitor 30 mg (average selling price). The results were weighted by typical re-dosing frequencies. A cost minimization analysis was used to compare the differences in processes required to achieve resolution of HAE attacks with Berinert® (CSL Behring, Marburg, Germany), Firazyr®(Shire, Lexington, US) and Kalbitor™ (Dyax Corp., Burlington, US). The differential costs were compared indirectly using the current, publically available prices of Berinert 20 IU/kg (average selling price), Firazyr 30 mg (wholesale acquisition cost +6%) and Kalbitor 30 mg (average selling price). The results were weighted by typical re-dosing frequencies. ResultsEstimates for re-dosing frequencies with approved HAE treatments were based on clinical trial data: 1% with Berinert, 7% with Firazyr, and 20% with Kalbitor. Since Berinert is dosed based on weight, its dosing in this analysis ranged from 2 to 5 vials (500 IU each) for patients weighing 50 to 150 kg. Per attack, Berinert was estimated to save the payers $79.29 to $4,659 with respect to Firazyr and $2,628 to $7,208 with respect to Kalbitor. Estimates for re-dosing frequencies with approved HAE treatments were based on clinical trial data: 1% with Berinert, 7% with Firazyr, and 20% with Kalbitor. Since Berinert is dosed based on weight, its dosing in this analysis ranged from 2 to 5 vials (500 IU each) for patients weighing 50 to 150 kg. Per attack, Berinert was estimated to save the payers $79.29 to $4,659 with respect to Firazyr and $2,628 to $7,208 with respect to Kalbitor. ConclusionsThe indirect comparison of on-demand treatment costs for HAE attacks estimated cost savings to the payer from use of Berinert vs. either Firazyr or Kalbitor for patients up to 330 pounds body weight. The indirect comparison of on-demand treatment costs for HAE attacks estimated cost savings to the payer from use of Berinert vs. either Firazyr or Kalbitor for patients up to 330 pounds body weight.