#4140 DAPRODUSTAT VERSUS RECOMBINANT HUMAN ERYTHROPOIETIN FOR TREATING ANAEMIA OF CHRONIC KIDNEY DISEASE: COST EFFECTIVENESS MODEL METHODOLOGY AND FINDINGS

Abstract Background and Aims Anaemia is a common manifestation in patients with chronic kidney disease (CKD).1,2 Daprodustat, hypoxia-inducible factor prolyl hydroxylase inhibitor, offers an alternative to conventional treatment recombinant human erythropoietins (rhEPOs). This study reports the development of cost-effectiveness analysis support reimbursement discussions for daprodustat Canada. Method A Markov model was developed conduct cost-utility compare expected costs outcomes associated daprodustat, vs two rhEPO comparators (darbepoetin alfa [DA] or epoetin [EA]), which represent standard care. The used lifetime time horizon, publicly funded Canadian healthcare payer perspective adults anaemia CKD (on/not on dialysis). Clinical inputs were obtained from Phase 3 clinical trials: ASCEND-D1 (daprodustat DA EA 2964 dialysis patients) ASCEND-ND2 3872 non-dialysis patients). Efficacy adverse event profiles both rhEPOs assumed equal. Patients entering (Figure) receive EA. includes five health states informed by ASCEND-D ASCEND-ND: non-dialysis, dialysis, transplant, post-transplantation terminal While state, utilities are assigned based three haemoglobin (Hb) levels: <10g/dL, 10–11.5g/dL >11.5g/dL. monthly cycle length utilised aligned ASCEND visits observations up Week 52. Hb concentrations ASCEND-ND estimate proportions target range 10–11.5g/dL, non-target levels. They have different utility values. could transition dialysis; latter die state. Transition probabilities derived data literature. median follow-up durations 2.5 1.9 years, respectively, necessitating extrapolation horizon; increases over applied. It that cannot back may death any mortality risks trials all-cause data. Costs included acquisition administration, cold-chain storage, transfusions red blood cells iron, events (AEs). All sourced fee schedules (2022 $CAD) Utilities levels trials; AE-associated decrements not be estimated due low rates – hence, disutilities Results In probabilistic reference case analysis, less costly (comparison DA: −$8763; EA:−$13,864) produced more quality-adjusted life years (DA: +0.012; EA: +0.018; Table). incremental savings versus −$860 −$1033, −$7904 −$12,831 Contributors cost include absence storage reduced administration costs. Conclusion indicates originates QALYs than CKD. this setting, provide public perspective. described here adapted other perspectives, including European countries.