Evaluating the cost per month of response for olutasidenib (OLU) versus ivosidenib (IVO) for patients with relapsed/refractory (R/R) mutant <i>IDH1</i> (m <i>IDH1</i> ) acute myeloid leukemia (AML).

Abstract

e18504 Background: In the United States (US), the incidence of AML has steadily increased over the past decade and is associated with substantial clinical and economic burden. Evaluating the cost effectiveness of treatment strategies can demonstrate the value of healthcare expenditure and support evidence-based clinical and payer decision-making. Methods: An economic model was developed to compare the cost per month of response for OLU and IVO for patients with R/R m IDH1 AML. Total costs per patient (regardless of response) were calculated for each therapy, including drug acquisition based on monthly drug prices and median treatment duration (4.7 mo OLU vs 4.1 mo IVO), monitoring, and adverse event (AE) management. US payer costs were sourced from public databases (e.g. HCUP). Clinical inputs were sourced from a previously conducted matching-adjusted indirect comparison and included complete remission (CR; 27% OLU vs 25% IVO), CR + CR with partial hematologic recovery (CRh; 29% OLU vs 33% IVO), duration of CR (21.3 mo OLU vs 10.1 mo IVO), duration of CR + CRh (17.5 mo OLU vs 8.2 mo IVO), and restricted mean survival time (15.6 mo OLU vs 12.2 mo IVO). AE frequencies, monitoring requirements, and treatment duration were taken from the FDA labels for each therapy. Sensitivity analyses were conducted to test assumptions regarding the AEs included and the treatment duration for each therapy. Results: Table 1 summarizes the results of the cost per month of response analysis. Monthly drug costs were comparable between therapies; however, median treatment duration was longer for OLU resulting in higher total costs for OLU than for IVO ($172,501 vs $150,680), with drug costs accounting for &gt;96% of the total costs for each treatment. Due to the longer duration of response for OLU, the cost per month of CR was 50% lower for OLU than IVO ($29,995 vs $59,675). Similarly, cost per month of CR + CRh and cost per month of survival were lower for OLU than IVO. The analysis demonstrated that treating one patient with OLU yields an expected 3.23 months of CR benefit versus IVO. The results of the sensitivity analyses were consistent with the base case. Conclusions: This analysis demonstrated that OLU is associated with a lower cost per month of CR and CR + CRh compared with IVO. To further assess the economic value, a full cost-effectiveness analysis capturing all costs and outcomes over a lifetime horizon is warranted. Results of the cost per month of response analysis for OLU vs. IVO for m IDH1 R/R AML. Analysis results per patient OLU (USD) IVO (USD) Total cost per month of CR $29,995 $59,675 Total cost per month of CR + CRh $33,990 $55,684 Total cost per month of survival $11,044 $12,321 Total costs $172,501 $150,680  Total drug costs $168,589 $145,051  Total monitoring costs $206 $872  Total AE costs $3,706 $4,757