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Early Cost-Effectiveness and Price Threshold Analyses of Resmetirom: An Investigational Treatment for Management of Nonalcoholic Steatohepatitis

Author

Listed:
  • Mehdi Javanbakht

    (Optimax Access Ltd, Kenneth Dibben House)

  • Jesse Fishman

    (Madrigal Pharmaceuticals, Inc.)

  • Eoin Moloney

    (Optimax Access Ltd, Kenneth Dibben House)

  • Peter Rydqvist

    (Madrigal Pharmaceuticals, Inc.)

  • Amir Ansaripour

    (Optimax Access Ltd)

Abstract

Background Nonalcoholic steatohepatitis (NASH) is characterized by inflammation and hepatocellular damage caused by accumulation of fat in the liver. Resmetirom (MGL-3196) is an orally administered, small-molecule, liver-targeted, selective thyroid hormone receptor-β agonist. This early analysis explored the potential cost effectiveness of resmetirom for the treatment of NASH from a US commercial payer perspective. Methods An early economic model was developed to reflect the clinical pathways typically followed by patients with NASH and liver fibrosis. Use of resmetirom, compared with placebo, was assessed. The Markov model structure was informed by a previous modeling study and a randomized, double-blind, placebo-controlled, phase II trial of resmetirom. Costs and outcomes were assessed over a lifetime time horizon with results presented in terms of cost per quality-adjusted life-year (QALY) gained. Results Resmetirom treatment resulted in increased costs of US$66,764 per patient, while increasing QALYs by 1.24. The incremental cost-effectiveness ratio was US$53,929 per QALY gained, indicating resmetirom treatment would potentially be cost effective at a willingness-to-pay (WTP) threshold of US$100,000. Results indicated that resmetirom would reduce the lifetime number of cases of decompensated cirrhosis (− 87), hepatocellular carcinoma (− 59), and liver transplants (− 30) per 1,000 patients compared with placebo. Resmetirom treatment remained cost effective at a US$100,000 WTP threshold up to a daily price point of US$72.00. Conclusion Resmetirom is a potentially cost-effective treatment option for patients with NASH and liver fibrosis based on an analysis performed from a US commercial payer perspective. Future economic analyses of the technology should, however, focus on overcoming the limitations of existing modeling methodology.

Suggested Citation

  • Mehdi Javanbakht & Jesse Fishman & Eoin Moloney & Peter Rydqvist & Amir Ansaripour, 2023. "Early Cost-Effectiveness and Price Threshold Analyses of Resmetirom: An Investigational Treatment for Management of Nonalcoholic Steatohepatitis," PharmacoEconomics - Open, Springer, vol. 7(1), pages 93-110, January.
  • Handle: RePEc:spr:pharmo:v:7:y:2023:i:1:d:10.1007_s41669-022-00370-2
    DOI: 10.1007/s41669-022-00370-2
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    References listed on IDEAS

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    2. David J. McLernon & John Dillon & Peter T. Donnan, 2008. "Systematic Review: Health-State Utilities in Liver Disease: A Systematic Review," Medical Decision Making, , vol. 28(4), pages 582-592, July.
    3. Alan Brennan & Stephen E. Chick & Ruth Davies, 2006. "A taxonomy of model structures for economic evaluation of health technologies," Health Economics, John Wiley & Sons, Ltd., vol. 15(12), pages 1295-1310, December.
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