Table 3.
Medical costs and data sources from CUA studies
| Author year, country (currency year, currency) | Patient population and patients compared | Sources of data | Cost category | Cost results (USD) |
|---|---|---|---|---|
| Wilson 2007 [46], UK (2005 GBP) |
Patients with active LN requiring induction therapy MMF vs. IV CYC |
A SLR of the literature identified two studies comparing MMF and IV CYC, reporting results following induction therapy [59, 60] Further data was extracted from a Cochrane review of all treatments [61] |
Total mean costs per 12 weeks (including medication, secondary care activity, and other monitoring): | |
| MMF: | 843.25 | |||
| IV CYC: | 1754.54 | |||
| No immunosuppressive therapy: | 90.83 | |||
| Mohara 2014 [40], Thailand (2012 Thai Baht) |
Patients with newly diagnosed severe LN receiving induction and maintenance therapy Four treatment regimes |
The PubMed database was searched using the following keywords: (lupus nephritis [MeSH]) AND (cyclophosphamide [MeSH] OR azathioprine [MeSH] OR mycophenolic acid [MeSH]) Only articles published between January 2000 and July 2012 that were written in English, Spanish, or Thai were considered. Study types that were considered included controlled clinical trials, randomized controlled trials, clinical trials, and comparative studies Ten studies met the inclusion criteria by giving details of the dosage of the drugs under consideration and examined the treatment outcomes for any of the five defined health states Costs sourced from national databases HCRU estimated from a medical record review on LN treatment at four tertiary care hospitals (laboratory tests and drug administrative costs) |
Mean (SE) cost of dialysis for patients with end-stage renal failure (per year) | 497,019 (4998) |
| Nee 2015 [41], USA (2013 US$) |
Patients with proliferative LN receiving maintenance therapy Different treatment regimes |
A Cochrane meta-analysis of maintenance therapy with MMF vs. AZA was performed using data from three clinical trials (MAINTAIN, ALMS, and Contreras’s study) and Red Book, and was the foundation of this base-case model | Mean costs (range) over 1 year | |
| Remission (nonpharmaceuticala): | 3368.34 (1263.13–2105.21 | |||
| Relapse (nonpharmaceuticala): | 6486.85 (2432.57–4054.29) | |||
| ESKD/dialysis: | 86,608 | |||
| Kim 2019 [35], China (Chinese Yuan) |
Patients with moderate-to-severe LN requiring induction therapy Different treatment regimes |
Three CUAs were identified and assessed from the SLR: Four different treatment regimens combining IV CYC, AZA, and MMF for long-term therapy in Thailand [40] MMF and AZA as maintenance treatments from a US perspective [41] MMF and IV CYC as induction treatments from a UK perspective [46] |
Medical costs of all patients in the ESKD state (per year) | 80,188 |
aCare provided by specialists, nonspecialists, nonphysician healthcare professionals, laboratory studies, imaging studies, emergency room visits, outpatient surgery, and hospitalizations
ALMS Aspreva Lupus Management Study, AZA azathioprine, CYC cyclophosphamide, CUA cost–utility analysis, ESKD end-stage kidney disease, GBP pound sterling, HCRU healthcare resource utilization, IV intravenous, LN lupus nephritis, MeSH Medical Subject Headings, MMF mycophenolate mofetil, NR not reported, SE standard error, SLR systematic literature review, UK United Kingdom, USA United States of America, US United States, US$ US dollar