New data presented by Mundipharma highlights a portfolio with cost efficient therapies

New data unveiled today by Mundipharma International Limited (Mundipharma) demonstrates that a number of key products within its network of independent associated companies’ portfolio, provide superior or comparable efficacy and value for money compared with current standards of care. Four abstracts from health economic studies from the UK across the respiratory, analgesic and oncology portfolios were presented at the European Congress of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR).

Speaking about the Mundipharma approach to product development within the current climate, Georg Toufar, Chief Marketing Officer said,

“Mundipharma recognises the current economic environment and resulting budget constraints for healthcare systems. As these studies show, our value proposition is aligned with the payer priority; providing patients access to better health care solutions while limiting clinical and financial risk exposure for the payer.”

1. Budget impact analysis of a new fixed-dose combination inhaler

The economic costs of asthma are among the highest for non-communicable diseases (NCDs) because of the substantial health service use, in many cases over a lifetime. The largest direct costs are for inpatient care and pharmaceuticals, whilst the principal indirect costs stem from loss of productivity due to missed work and school¹. With this in mind, any savings that can be made from a treatment perspective are likely to be viewed favourably from a payer perspective.

Assuming similar levels of inhaled corticosteroid (ICS) use with two fixed-dose combination regimens, this Mundipharma analysis estimates the budget impact of using a fixed-dose combination inhaler of fluticasone propionate and formoterol fumarate (flutiform®) as an alternative to fluticasone propionate and salmeterol xinafoate (Seretide®Evohaler®) in adult asthma patients, for an average NHS clinical commissioning group (CCG) in England². The abstract reports that annual drug acquisition costs per person were lower with flutiform® than with Seretide Evohaler. Referencing a clinical trial that had compared the two treatments, the abstract concluded that the former is a cost-saving option, from a NHS England CCG perspective, for the treatment of adult asthma patients requiring combination therapy using a pressurised metered dose inhaler (pMDI)³.

2. The potential of a reduction in the risk of opioid-related fractures to drive the cost-effectiveness of an analgesic

An increased risk of fractures has been observed in patients treated with opiates, possibly resulting from falls related to the central nervous system effects such as dizziness. The objective of this UK based study was to explore whether transdermal buprenorphine (BuTrans® 5 μg/h, 10 μg/h and 20 μg/h Transdermal Patch) has the potential to be cost effective due to a reduced risk for fracture⁴.

Real-world hospital discharge data were applied to the risk for fracture in the general population. For a population of 100,000, the model predicted a reduction in the number of additional fractures associated with analgesic use from over 2,000 for patients treated with tramadol to under 20 for patients treated with the buprenorphine patch. An estimated £5.5 million was saved and over 1,300 quality-adjusted life years (QALYs) were gained. Overall, the study concluded that buprenorphine has the potential to be dominant and cost-effective compared to tramadol.

3. An evaluation of the quality of life benefits and cost impact of oxycodone/naloxone in patients with moderate to severe pain and opioid-induced constipation

This study evaluated the quality of life benefits and cost impact of prolonged release oxycodone hydrochloride/naloxone hydrochloride (Targinact®) which is indicated for severe pain which can be managed only by opioid analgesics and also counteracts opioid-induced constipation (OIC)⁵. Using data from three randomised controlled trials (RCTs), a subgroup of patients who had OIC and who had also already failed on two or more laxatives at screening (n=178) was applied for the analysis. The study concluded that patients treated with oxycodone/naloxone experienced a quality of life gain and an incremental cost-effectiveness ratio (ICER) of £7,821.80 which is considerably below thresholds normally regarded as cost effective in England and Wales (£20,000-30,000 per QALY⁶).

4. An evaluation of the cost-effectiveness of bendamustine-rituximab in first-line treatment of patients with advanced indolent non-Hodgkin’s lymphoma

The fourth study evaluated the cost-effectiveness of bendamustine hydrochloride (Levact®) given with rituximab (B-R), compared with standard of care in the first-line treatment of patients with advanced indolent non-Hodgkin’s lymphoma (iNHL)* in England and Wales⁷.

The UK analysis showed that the ICERs for B-R vs. CHOP-R (cyclophosphamide, doxorubicin, vincristine, prednisone and rituximab) and B-R vs CVP-R (cyclophosphamide, vincristine, prednisone, and rituximab) were £5,249 and £8,092 respectively. Both ICERs were well below the thresholds normally regarded as cost-effective in England and Wales (£20,000 – 30,000 per QALY).

*NB: Levact is not licensed for first-line use in iNHL

Together, these studies demonstrate Mundipharma’s approach and commitment to improving patient experience and clinical outcomes, but also to providing value to payers.

Speaking about Mundipharma’s approach to bringing products to market, Francois Bernard, Head of Market Access, Mundipharma International Limited said,

“The Mundipharma value proposition comes with a built-in ‘insurance policy’ for payers. We choose to work with molecules for which the medical concepts are already well proven; they have well established safety and tolerability profiles; clearly defined patient populations; and deliver positive health outcomes. We then share this value with payers, minimising uncertainty around the impact on their budgets and patient outcomes.”

References

1.  http://www.globalasthmareport.org/impact/burden.php
2. Dunlop, W., Heron, L., Fox, G. et al. Budget impact analysis of a new fixed-dose combination inhaler for a clinical commissioning group within the National Health Service in England. Research conducted by Adelphi Values, presented at European Congress of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR), 2-6 November, Dublin, Ireland.
3. Bodzenta-Lukaszyk A., Pulka G., Dymek A., Bumbacea D., McIver T., Schwab B. et al. Efficacy and safety of fluticasone and formoterol in a single pressurized metered dose inhaler. Respiratory Medicine. 2011; 105(5):674-82.
4. Cawson, M., Knight, C., Hirst, M. et al. The potential of a reduction in the risk of opioid-related fractures to drive the cost-effectiveness of an analgesic. RTI Health Solutions, presented at European Congress of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR), 2-6 November, Dublin, Ireland.
5. Dunlop W., Neufeld K. et al. Quality of life benefits and cost impact of prolonged release oxycodone/naloxone versus prolonged release oxycodone in patients with moderate to severe pain and opioid-induced constipation despite the use of 2 laxatives: a UK cost utility analysis. Presented at European Congress of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR), 2-6 November, Dublin, Ireland.
6. http://www.nice.org.uk/newsroom/features/measuringeffectivenessandcosteffectivenesstheqaly.jsp 
7. Dewilde, S., Woods, B., Castaigne, J-G et al. Cost-effectiveness of bendamustine-rituximab in first-line indolent NHL: A patient-level simulation. Presented at European Congress of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR), 2-6 November, Dublin, Ireland.