Abstracts for cost-effectiveness data and budget-impact model published in the Journal of Managed Care & Specialty Pharmacy (JMCP)
INPEFA recently approved by FDA for treatment of heart failure
THE WOODLANDS, Texas, Oct. 17, 2023 (GLOBE NEWSWIRE) — Lexicon Pharmaceuticals, Inc. (NASDAQ:LXRX) today highlighted upcoming presentations of two studies demonstrating positive financial impact of INPEFA® (sotagliflozin) at the Academy of Managed Care Pharmacy (AMCP) Nexus 2023 National Meeting, October 16-19, 2023, at the Orlando World Center Marriott, Expo Hall, Cypress 1 and 2, Orlando, Florida.
Highlights from the published abstracts:
“Economic impact of sotagliflozin among patients with heart failure: Budget impact analysis from US payer perspective”
The objective of this study was to quantify the payer budget impact of sotagliflozin following FDA approval in May 2023, and market entry one month later.
The budget impact was modeled as the change in medical and pharmacy costs from using sotagliflozin in addition to the standard of care (SoC) compared with the SoC alone among U.S. patients hospitalized with heart failure (HF). Costs included pharmacy, inpatient, emergency department visits, and other medical and adverse event costs. Budget impact was measured separately for commercial payer and all-payer scenarios.
Amongst treated patients on sotagliflozin, commercial payers incurred increased pharmacy costs of $7,276 per patient per year as compared to patients on SoC alone. However, reduced readmission rates and post-acute emergency department visits in treated patients on sotagliflozin contributed to a relative reduction in annual medical costs of $4,729 per patient per year (sotagliflozin $9,825 vs. SoC $14,554), resulting in an increase in total spending per patient of $2,547 per year (sotagliflozin $17,101 vs. SoC $14,554) for commercial payers. In the all-payer scenario, annual medical costs per patient per year were reduced on a relative basis by $2,367 (sotagliflozin $4,920 vs. SoC $7,287), resulting in an increase in total spending per patient of $4,909 per year (sotagliflozin $12,196 vs. SoC $7,287) for all payers. The resulting estimated financial impact across the entire health plan during the first year was an increase of $0.05 per member per month in the commercial scenario and an increase of $0.17 per member per month in the all-payer scenario.
The authors concluded that “Health plans adopting sotagliflozin can expect to see an increase in pharmacy costs, but about one-third of this cost was offset by lower medical cost.”
“Cost-effectiveness of sotagliflozin for the treatment of patients with diabetes and recent worsening heart failure”
The objective of this study was to quantify the cost-effectiveness of sotagliflozin compared with SoC from a U.S. payer perspective for the treatment of patients hospitalized with HF and comorbid type 2 diabetes (T2D). Clinical outcomes of interest were hospital readmissions, emergency department (ED) visits, and all-cause deaths after an HF hospitalization. Patient health benefit was quantified using quality-adjusted life years (QALYs). Costs included pharmaceutical costs and costs from rehospitalizations, ED visits, and adverse events. Economic value was measured using the incremental cost-effectiveness ratio.
Study results showed reductions in annualized rehospitalization rates, annualized ED visits, and annualized mortality in patients treated with sotagliflozin as compared to SoC, resulting in a net relative increase in QALYs of 0.425 (sotagliflozin 2.305 vs. SoC 1.880). Driven by increased pharmaceutical costs, use of sotagliflozin increased total costs by $19,374 over the lifetime of patients treated with sotagliflozin as compared to SoC ($31,953 vs. $12,579), yielding an incremental cost-effectiveness ratio of $45,596 per increased QALY.
The authors concluded that “sotagliflozin is a cost-effective treatment for HF among patients with T2D and a recent HF hospitalization or urgent care visit.”
“The studies presented at AMCP Nexus 2023 serve as evidence that INPEFA is an affordable treatment that offers important clinical value for heart failure patients, and significant financial value for payers,” said Craig Granowitz, M.D., Ph.D., Lexicon’s senior vice president and chief medical officer. “We anticipate that these results will help facilitate meaningful dialogue and provide support for positive decisions from formulary decision-makers.”
Abstracts for each study are available in the Poster Abstracts Supplement to the Journal of Managed Care & Specialty Pharmacy (JMCP), which can be found here.
On May 26, 2023, the U.S. Food and Drug Administration approved INPEFA, a once-daily oral tablet, to reduce the risk of cardiovascular death, hospitalization for heart failure, and urgent heart failure visit in adults with:
- heart failure or
- type 2 diabetes mellitus, chronic kidney disease, and other cardiovascular risk factors.
- type 2 diabetes mellitus, chronic kidney disease, and other cardiovascular risk factors.
