Modelling cost effectiveness of horse antithymocyte globulin for treating severe aplastic anaemia in Germany.

This research article discusses the cost effectiveness of using horse antithymocyte globulin (h-ATG) versus rabbit antithymocyte globulin (r-ATG) in treating severe aplastic anaemia (AA) in Germany, with the findings favoring h-ATG.

Introduction

• Severe aplastic anaemia (AA) is a serious condition caused by the failure of bone marrow due to an immune trigger. The best treatment for patients who can’t undergo bone marrow transplantation is immunosuppression through a combined treatment of antithymocyte globulin (ATG) and cyclosporine.
• There’s a debate about whether horse antithymocyte globulin (h-ATG) or rabbit antithymocyte globulin (r-ATG) should be used for treatment. Recently, h-ATG is favored but it was withdrawn from the European market in 2007.
• The withdrawal of h-ATG has led to questions about its cost effectiveness and whether it’s a sensible investment given the healthcare budgets and patient health. Often reimbursement for imported h-ATG preparations from outside Europe is frequently rejected in negotiations with statutory health insurance companies.

Methodology

• The researchers modeled the cost effectiveness of r-ATG versus h-ATG based on data from a recent randomised trial and cost data from the hospital pharmacy of Jena University Hospital.
• The amount of life years gained and the average additional costs per life year gained were calculated in a comparison between h-ATG and r-ATG.

Results

• The calculations showed average added costs per life year gained of less than €11,033.80 for the patient population treated with h-ATG as compared to r-ATG.
• By assuming a cost effectiveness threshold of €25,000-35,000 achieved per life year gained, the calculations revealed cost effectiveness of h-ATG compared to r-ATG.

Conclusion

• In conclusion, the study revealed h-ATG as a cost-effective treatment for severe aplastic anaemia compared to r-ATG.
• This points towards the need for healthcare policy to review their stance on imported h-ATG and consider its inclusion in reimbursement considerations.