Cost comparison of intravenous immunoglobulin and subcutaneous efgartigimod in patients with chronic inflammatory demyelinating polyneuropathy.
Panzyga treatment pathways were associated with lower total treatment costs and cost per responder compared to Vyvgart hytrulo at both 6 and 12 months.
Where it sits
this study against the rest of the efpeglenatide corpusSummary and findings
This study compared total treatment costs and cost per responder for intravenous immunoglobulin (Panzyga) and subcutaneous efgartigimod (Vyvgart hytrulo) in adults with chronic inflammatory demyelinating polyneuropathy. Costs were analyzed over 6 and 12 months, with findings indicating lower costs associated with Panzyga. No therapeutic claims are made regarding efficacy or safety.
Abstract
<h4>Aims</h4>To compare the total treatment costs and cost per responder of IVIG and a newer therapy for adults with chronic inflammatory demyelinating polyneuropathy from a U.S. payer perspective.<h4>Methods</h4>A cost per responder analysis compared Vyvgart hytrulo with Panzyga administered at standard (1 g/kg) and higher (2 g/kg) maintenance doses over 6- and 12-month time horizons. Efficacy, safety data, and responder definitions were sourced from the ADHERE trial for Vyvgart hytrulo, and the ProCID trial for Panzyga. Total treatment costs included drug acquisition, administration, and costs by responder status reported in 2026 USD. Twelve-month Panzyga response rates incorporated published evidence and clinical guideline assumptions for responders, non-responders, and those with inadequate initial response requiring dose escalation. Deterministic scenario analyses evaluated reduced Panzyga effectiveness and hypothetical Vyvgart Hytrulo average sales price (ASP) discounts. Threshold analyses identified the efficacy reduction and ASP discount required to change the model conclusions. Probabilistic sensitivity analysis evaluated parameter uncertainty in the clinical response estimates.<h4>Results</h4>At 6 months, total treatment costs for Panzyga 1 g/kg, Panzyga 2 g/kg, and Vyvgart hytrulo were $124,812, $217,366, and $464,681, respectively. At 12 months, costs were $190,026, $402,301, and $698,583, respectively. Six-month responder rates were 80%, 92%, and 53% for Panzyga 1 g/kg, Panzyga 2 g/kg, and Vyvgart hytrulo, respectively; corresponding 12-month rates were 74%, 85%, and 48%. Cost-per-responder was consistently lower for Panzyga versus Vyvgart hytrulo at both time horizons. At 12 months, cost per responder was $256,792 for Panzyga 1 g/kg, $473,295 for Panzyga 2 g/kg, and $1,455,382 for Vyvgart hytrulo.<h4>Limitations</h4>While no head-to-head clinical trial data were available, differences in trial design and responder definitions between studies may affect comparability.<h4>Conclusions</h4>Under the assumptions of this model, Panzyga-based treatment pathways were associated with lower modeled total treatment costs and lower estimated cost per responder than Vyvgart hytrulo at both 6 and 12 months.
Background
This paper addresses the cost-effectiveness of intravenous immunoglobulin (IVIG) compared to a newer therapy, efgartigimod, in treating chronic inflammatory demyelinating polyneuropathy (CIDP). Previous studies have established the efficacy of these treatments, but cost comparisons are limited. Understanding the economic implications of these therapies is crucial for healthcare decision-making.
Methods
A cost per responder analysis was performed comparing Vyvgart hytrulo with Panzyga at standard (1 g/kg) and higher (2 g/kg) maintenance doses over 6- and 12-month periods. The study sourced efficacy and safety data from the ADHERE trial for Vyvgart hytrulo and the ProCID trial for Panzyga. Total treatment costs included drug acquisition, administration, and costs based on responder status.
Results
At 6 months, total treatment costs were $124,812 for Panzyga 1 g/kg, $217,366 for Panzyga 2 g/kg, and $464,681 for Vyvgart hytrulo. At 12 months, costs were $190,026 for Panzyga 1 g/kg, $402,301 for Panzyga 2 g/kg, and $698,583 for Vyvgart hytrulo. Responder rates at 6 months were 80% for Panzyga 1 g/kg, 92% for Panzyga 2 g/kg, and 53% for Vyvgart hytrulo, with corresponding rates at 12 months being 74%, 85%, and 48%. Cost per responder was lower for Panzyga compared to Vyvgart hytrulo at both time points.
Interpretation
The findings suggest that Panzyga may offer a more cost-effective treatment option compared to Vyvgart hytrulo, particularly when considering cost per responder. However, the effect sizes should be interpreted with caution, as the differences in responder definitions and trial designs could limit comparability. This analysis highlights the importance of economic evaluations in treatment decisions but does not provide direct clinical outcomes.
Key findings
- $124,812 total treatment cost for Panzyga 1 g/kg at 6 months.
- $190,026 total treatment cost for Panzyga 1 g/kg at 12 months.
- $464,681 total treatment cost for Vyvgart hytrulo at 6 months.
- $698,583 total treatment cost for Vyvgart hytrulo at 12 months.
- 80% responder rate for Panzyga 1 g/kg at 6 months.
- $256,792 cost per responder for Panzyga 1 g/kg at 12 months.
Limitations
- No head-to-head clinical trial data available.
- Differences in trial design may affect comparability.
- Responder definitions varied between studies.