Long-Term Cost-Effectiveness of Valbenazine and Deutetrabenazine For Tardive Dyskinesia

Abstract Background Hybrid emergency room (ER) systems, consisting of an angiography-computed tomography (CT) machine in a trauma resuscitation room, are reported to be effective for reducing death from exsanguination in trauma patients. We aimed to investigate the cost-effectiveness of a hybrid ER system in severe trauma patients without severe traumatic brain injury (TBI). Methods We conducted a cost-utility analysis comparing the hybrid ER system to the conventional ER system from the perspective of the third-party healthcare payer in Japan. A short-term decision tree and a long-term Markov model using a lifetime time horizon were constructed to estimate quality-adjusted life years (QALYs) and associated lifetime healthcare costs. Short-term mortality and healthcare costs were derived from medical records and claims data in a tertiary care hospital with a hybrid ER. Long-term mortality and utilities were extrapolated from the literature. The willingness-to-pay threshold was set at $47,619 per QALY gained and the discount rate was 2%. Deterministic and probabilistic sensitivity analyses were conducted. Results The hybrid ER system was associated with a gain of 1.03 QALYs and an increment of $33,591 lifetime costs compared to the conventional ER system, resulting in an ICER of $32,522 per QALY gained. The ICER was lower than the willingness-to-pay threshold if the odds ratio of 28-day mortality was < 0.66. Probabilistic sensitivity analysis indicated that the hybrid ER system was cost-effective with a 79.3% probability. Conclusion The present study suggested that the hybrid ER system is a likely cost-effective strategy for treating severe trauma patients without severe TBI.

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RE: Cost-effectiveness of valbenazine compared with deutetrabenazine for the treatment of tardive dyskinesia

Journal of Medical Economics ◽

10.1080/13696998.2021.1948230 ◽

2021 ◽

pp. 1-1

Author(s):

Weiguang Xue ◽

Rinat Ribalov ◽

Zheng-Yi Zhou ◽

Rajeev Ayyagari ◽

Sam Leo

Keyword(s):

Cost Effectiveness ◽

Tardive Dyskinesia

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Cost-Effectiveness and Cost-Utility of Long-Term Management Strategies for Heartburn

Value in Health ◽

10.1046/j.1524-4733.2002.54145.x ◽

2002 ◽

Vol 5 (4) ◽

pp. 312-328 ◽

Cited By ~ 19

Author(s):

Ron Goeree ◽

Bernie J. O'Brien ◽

Gordon Blackhouse ◽

John Marshall ◽

Andrew Briggs ◽

...

Keyword(s):

Cost Effectiveness ◽

Management Strategies ◽

Cost Utility ◽

Term Management

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Onset and Resolution of Key Adverse Events in Valbenazine-Treated Patients with Tardive Dyskinesia: Pooled Analyses from Two Long-Term Clinical Trials

CNS Spectrums ◽

10.1017/s1092852920002394 ◽

2021 ◽

Vol 26 (2) ◽

pp. 151-151

Author(s):

Stephen R. Marder ◽

Jean-Pierre Lindenmayer ◽

Chirag Shah ◽

Tara Carmack ◽

Angel S. Angelov ◽

...

Keyword(s):

Clinical Trials ◽

Adverse Events ◽

Tardive Dyskinesia ◽

Suicidal Behavior ◽

Prolonged Exposure ◽

First Occurrence ◽

Balance Disorder ◽

Clinical Interest ◽

Post Hoc

AbstractObjectiveTardive dyskinesia (TD) is a persistent and potentially disabling movement disorder associated with prolonged exposure to antipsychotics and other dopamine receptor blocking agents. Long-term safety of the approved TD medication, valbenazine, was demonstrated in 2 clinical trials (KINECT 3 [NCT02274558], KINECT 4 [NCT02405091]). Data from these trials were analyzed post hoc to evaluate the onset and resolution of adverse events (AEs).MethodsParticipants in KINECT 3 and KINECT 4 received up to 48 weeks of once-daily valbenazine (40 or 80 mg). Data from these studies were pooled and analyzed to assess the incidence, time to first occurrence, and resolution for the following AEs of potential clinical interest: akathisia, balance disorder, dizziness, parkinsonism, somnolence/sedation, suicidal behavior/ideation, and tremor.ResultsIn the pooled population (N=314), all AEs of potential clinical interest occurred in <10% of participants, with somnolence (9.6%), suicidal behavior/ideation (6.4%), and dizziness (5.7%) being the most common AEs. Mean time to first occurrence ranged from 36 days (akathisia [n=9]) to 224 days (parkinsonism [n=2]). By end of study (or last study visit), resolution of AEs was as follows: 100% (suicidal ideation/behavior, parkinsonism); >85% (somnolence/sedation, dizziness); >70% (akathisia, balance disorder, tremor).ConclusionsIn long-term clinical trials, the incidence of AEs of potential clinical interest was low (<10%) and most were resolved by end of treatment (>70–100%). All patients taking valbenazine should be routinely monitored for AEs, particularly those that may exacerbate the motor symptoms associated with TD.FundingNeurocrine Biosciences, Inc.

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Real-world evaluation of patient characteristics and disease management in long-term valbenazine treatment in adults with Tardive dyskinesia

Parkinsonism & Related Disorders ◽

10.1016/j.parkreldis.2020.06.426 ◽

2020 ◽

Vol 79 ◽

pp. e117-e118

Author(s):

S. Siegert ◽

C. Yonan ◽

N. Longo ◽

H. Cratty ◽

M. Nicosia ◽

...

Keyword(s):

Disease Management ◽

Tardive Dyskinesia ◽

Real World ◽

Patient Characteristics

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First-Line Atezolizumab Plus Bevacizumab versus Sorafenib in Hepatocellular Carcinoma: A Cost-Effectiveness Analysis

Cancers ◽

10.3390/cancers13050931 ◽

2021 ◽

Vol 13 (5) ◽

pp. 931

Author(s):

Chi-Leung Chiang ◽

Sik-Kwan Chan ◽

Shing-Fung Lee ◽

Horace Cheuk-Wai Choi

Keyword(s):

Hepatocellular Carcinoma ◽

Cost Effectiveness ◽

Lifetime Cost ◽

Cost Effective ◽

First Line ◽

First Line Therapy ◽

Payer Perspective ◽

Life Years ◽

Using Data

Background: The IMbrave 150 trial revealed that atezolizumab plus bevacizumab (atezo–bev) improves survival in patients with unresectable hepatocellular carcinoma (HCC) (1 year survival rate: 67.2% vs. 54.6%). We assessed the cost-effectiveness of atezo–bev vs. sorafenib as first-line therapy in patients with unresectable HCC from the US payer perspective. Methods: Using data from the IMbrave 150, we developed a Markov model to compare the lifetime cost and efficacy of atezo–bev as first-line systemic therapy in HCC with those of sorafenib. The main outcomes were life-years, quality-adjusted life-years (QALYs), lifetime costs, and incremental cost-effectiveness ratio (ICER). Results: Atezo–bev demonstrated a gain of 0.44 QALYs, with an additional cost of USD 79,074. The ICER of atezo–bev was USD 179,729 per QALY when compared with sorafenib. The model was most sensitive to the overall survival hazard ratio and body weight. If we assumed that all patients at the end of the IMbrave 150 trial were cured of HCC, atezo–bev was cost-effective (ICER USD 53,854 per QALY). However, if all patients followed the Surveillance, Epidemiology, and End Results data, the ICER of atezo–bev was USD 385,857 per QALY. Reducing the price of atezo–bev by 20% and 29% would satisfy the USD 150,000/QALY and 100,000/QALY willingness-to-pay threshold. Moreover, capping the duration of therapy to ≤12 months or reducing the dosage of bev to ≤10 mg/kg would render atezo–bev cost-effective. Conclusions: The long-term effectiveness of atezo–bev is a critical but uncertain determinant of its cost-effectiveness. Price reduction would favorably influence cost-effectiveness, even if long-term clinical outcomes were modest. Further studies to optimize the duration and dosage of therapy are warranted.

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