--- title: "Bezuclastinib in Nonadvanced systemic mastocytosis: cost-effectiveness analyses and utility weights" description: "Published cost-effectiveness analyses and health-state utility weights for Bezuclastinib in Nonadvanced systemic mastocytosis, each value quoted from the article: 5 cost-effectiveness analyses and 3 studies reporting utility weights. Analyses: Add-on omalizumab versus standard of care in moderate or severe chronic spontaneous urticaria with inadequate response to standard of care, United Kingdom: Graham et al. (2016); Omalizumab versus updosed H1-antihistamines in chronic spontaneous urticaria, Netherlands: Kanters et al. (2018); Targeted gene testing with tailored first-line therapy versus empirical imatinib in metastatic gastrointestinal stromal tumor, United States: Banerjee et al. (2020); Ripretinib plus best supportive care versus best supportive care in fourth-line or later advanced gastrointestinal stromal tumors, United States: Liao et al. (2021); 1 further article. Utility weights: Utility weights by Urticaria Activity Score health state, chronic spontaneous urticaria: Graham et al. (2016); Utility weights for living with and without chronic urticaria, chronic spontaneous urticaria: Shaker et al. (2020); Utility weights for moderate and severe allergic reactions, food allergy, and anaphylaxis, peanut allergy: Shaker et al. (2021). Every value is a verbatim quote from the primary article it is shown with." canonical: "https://www.evicenter.com/drugs/bezuclastinib--nonadvanced-systemic-mastocytosis/cost-effectiveness-analyses" published: "2026-10-22T07:49:06-04:00" modified: "2026-10-22T07:49:06-04:00" --- # Bezuclastinib in Nonadvanced systemic mastocytosis: cost-effectiveness analyses and utility weights Published cost-effectiveness analyses and health-state utility weights that a model of this product could cite, adapt, or compare against, grouped by how each article relates to the product and its indication. Every value is quoted from the article it cites, and section 3 lists the searches that found the articles. ## Overview | Item | Detail | | --- | --- | | Literature searched | Tufts Medical Center Cost-Effectiveness Analysis Registry, searched October 21, 2026; the queries are listed in section 3. | | Cost-effectiveness analyses | 5 | | Studies reporting utility weights | 3 | ## 1 Cost-effectiveness analyses ### 1.1 Analyses of Bezuclastinib No evidence found. ### 1.2 Treatments for the same indication No evidence found. ### 1.3 The same disease in other populations or settings No evidence found. ### 1.4 Related diseases and analogous treatments #### Add-on omalizumab versus standard of care in moderate or severe chronic spontaneous urticaria with inadequate response to standard of care, United Kingdom: Graham et al. (2016) Relevance: Evaluates add-on omalizumab, the anti-IgE antibody that section 2 lists as off-label therapy for recurrent uncontrolled anaphylaxis in mastocytosis, against standard of care in moderate or severe chronic spontaneous urticaria from a UK societal perspective, a model with health states defined by symptom score. > “The aim of this study was to assess the cost utility of add-on omalizumab treatment compared with standard of care (SOC) in moderate or severe CSU patients with inadequate response to SOC, from the UK societal perspective.” > “A de novo Markov model consisting of eight states that captured the major characteristics of CSU was constructed in Microsoft® Excel 2010” > “The base-case model was run over a 20-year time horizon as it was anticipated that the majority of patients would have entered spontaneous remission by 20 years following symptom onset.” > “Both costs and health effects were discounted at a rate of 3.5 %” > “All costs were inflated to 2014 values where necessary, using the UK Consumer Price Index for Outpatient Services (May 2014)” > “In the base-case analysis, omalizumab was associated with increased cost but also increased benefit (QALYs) compared with SOC, with a deterministic ICER of £3183 per QALY” > “Results of the probabilistic model were consistent with those of the deterministic model, with a mean probabilistic ICER of £3395 per QALY.” > “Considering the narrower NHS/PSS perspective, which excludes societal costs, the incremental costs of omalizumab are substantially higher, leading to an ICER of over £35,000 per QALY.” Source: [Graham et al. (2016)](https://pmc.ncbi.nlm.nih.gov/articles/PMC4929169/) #### Omalizumab versus updosed H1-antihistamines in chronic spontaneous urticaria, Netherlands: Kanters et al. (2018) Relevance: Evaluates omalizumab, the anti-IgE antibody listed in section 2, against updosed H1-antihistamines as standard of care in chronic spontaneous urticaria in the Netherlands from a societal perspective. > “To determine the cost-effectiveness of omalizumab relative to standard of care (SoC; up to four times the daily dose of H1 -antihistamines) in the Netherlands from a societal perspective.” > “The Markov model used consisted of five health states based on Urticaria Activity Score over 7 days.” > “Healthcare consumption, quality of life (using EuroQol-5D) and productivity losses were derived from a burden-of-illness study (ASSURE-CSU) among 93 Dutch patients.” > “A 10-year time horizon was used.” > “The incremental cost-effectiveness ratio (ICER) of omalizumab vs. SoC was €17 502 per quality-adjusted life-year (QALY) gained.” > “Productivity costs played an important role in the value of the ICER; discarding productivity costs resulted in an ICER of €85 310 per QALY.” Source: [Kanters et al. (2018)](https://pubmed.ncbi.nlm.nih.gov/29476533/) #### Targeted gene testing with tailored first-line therapy versus empirical imatinib in metastatic gastrointestinal stromal tumor, United States: Banerjee et al. (2020) Relevance: Evaluates targeted gene testing to direct first-line tyrosine kinase inhibitor therapy against empirical imatinib in metastatic gastrointestinal stromal tumors in the United States, a model of KIT-directed oral tyrosine kinase inhibitor selection. > “We developed a Markov model to compare the cost-effectiveness of targeted gene testing (TGT) and variation-directed first-line therapy compared with empirical imatinib therapy for patients with metastatic GIST from the US payer perspective.” > “Cycle length was defined as 2 months, based on the National Comprehensive Cancer Network recommendation for assessment of disease progression, and the model time horizon was 10 years.” > “All costs were adjusted for inflation to 2019 US dollars using the consumer price index.” > “An annual discounting rate of 3% was applied for cost and effectiveness.” > “Therapy directed by TGT was associated with an increase of 0.10 QALYs at a cost of $9513 compared with the empirical imatinib approach, leading to an incremental cost-effectiveness ratio of $92 100.” > “Probabilistic sensitivity analysis found that TGT-directed therapy was considered cost-effective 70% of the time.” Source: [Banerjee et al. (2020)](https://pmc.ncbi.nlm.nih.gov/articles/PMC7522695/) #### Ripretinib plus best supportive care versus best supportive care in fourth-line or later advanced gastrointestinal stromal tumors, United States: Liao et al. (2021) Relevance: Evaluates ripretinib, an oral KIT tyrosine kinase inhibitor, against best supportive care in advanced gastrointestinal stromal tumors in the United States from a health care payer perspective. > “We used a Markov model with three health states: progression-free disease, progression disease and death. We parameterized the model from time-to-event data (progression-free survival, overall survival) of ripretinib and placebo arms in the INVICTUS trial and extrapolated to a patient’s lifetime horizon.” > “A discount rate of 3% per annum was used for costs and health benefits, and a half-cycle correction was included.” > “this analysis took the payer’s perspective.” > “The base-case model projected improved outcomes (by 0.29 QALYs) and additional costs (by $70,251) and yielded an ICER of $244,010/QALY gained for ripretinib versus placebo.” > “Probabilistic sensitivity analyses revealed that ripretinib was the cost-effective therapy in 41.1% of simulations at the willingness-to-pay (WTP) threshold of $150,000.” > “Ripretinib would achieve its cost-effectiveness with a price discount of 56% given the present effectiveness.” Source: [Liao et al. (2021)](https://pmc.ncbi.nlm.nih.gov/articles/PMC8685288/) #### Universal prescription of two epinephrine autoinjectors versus risk-stratified prescription in peanut allergy, United States and United Kingdom: Shaker et al. (2021) Relevance: Evaluates universal against risk-stratified prescribing of two epinephrine autoinjectors for peanut allergy from United States and United Kingdom perspectives, a model of the emergency epinephrine preparedness that section 2 describes for patients with prior severe anaphylaxis. > “To evaluate the cost-effectiveness of routinely prescribing all patients 2 EAI devices versus a risk-stratified approach (2 EAIs prescribed only for patients with a risk factor).” > “Markov models compared universal versus risk-stratified approaches on the basis of either a previous medical history of anaphylaxis (PMH-ana) or anaphylaxis requiring multiple epinephrine doses (multi-epi).” > “Cohorts of children with peanut allergy were evaluated over an 80-year time horizon from both US and UK societal and health care perspectives.” > “Cost-effectiveness threshold was $100,000/quality-adjusted life-year (QALY).” > “From a US perspective, universal prescription of 2 EAIs to all patients with peanut allergy was not cost-effective in the base case versus risk stratification by PMH-ana.” > “Universal prescription of 2 EAIs was associated with an incremental cost of $10,696,036/QALY versus the PMH-ana strategy, and $17,514,558/QALY versus the multi-epi strategy.” > “From a UK perspective, universally prescribing 2 EAIs was also not cost-effective (incremental cost of $4,132,440/QALY vs PMH-ana and $6,208,227/QALY vs multi-epi) at single device costs more than $18.” Source: [Shaker et al. (2021)](https://pubmed.ncbi.nlm.nih.gov/33486143/) ## 2 Utility weights ### 2.1 Utility weights from analyses of Bezuclastinib No evidence found. ### 2.2 Utility weights for the same indication No evidence found. ### 2.3 Utility weights for the same disease in other populations or settings No evidence found. ### 2.4 Utility weights for related diseases and analogous treatments #### Utility weights by Urticaria Activity Score health state, chronic spontaneous urticaria: Graham et al. (2016) Relevance: Utilities for chronic spontaneous urticaria by symptom severity, from urticaria-free to severe, a mast cell-mediated condition treated with the antihistamines and anti-IgE therapy listed in section 2. > “Health outcomes were measured in quality-adjusted life-years (QALYs), with utilities for each of the five health states (Table 2) based on a published mixed-effects regression model constructed from pooled EQ-5D data across the GLACIAL, ASTERIA I and ASTERIA II trials” Source: [Graham et al. (2016)](https://pmc.ncbi.nlm.nih.gov/articles/PMC4929169/) | Health state | Utility | | --- | --- | | “Severe urticaria” “(UAS7 = 28–42)” | “0.712 (0.31; Beta)” | | “Moderate urticaria” “(UAS7 = 16–27)” | “0.782 (0.26; Beta)” | | “Mild urticaria” “(UAS7 = 7–15)” | “0.845 (0.24; Beta)” | | “Well-controlled urticaria” “(UAS7 = 1–6)” | “0.859 (0.24; Beta)” | | “Urticaria-free” “(UAS7 = 0)” | “0.897 (0.25; Beta)” | Source: [Graham et al. (2016)](https://pmc.ncbi.nlm.nih.gov/articles/PMC4929169/) #### Utility weights for living with and without chronic urticaria, chronic spontaneous urticaria: Shaker et al. (2020) Relevance: Utilities for living with and without chronic urticaria, from a model of screening laboratory testing in adults with chronic urticaria. Access: Not open access Not quoted: The utility weights are reported in the full text, which is closed access. > “A Markov model using cohort analysis and microsimulations was created for adult patients aged 20 years, over a 10-year time horizon, randomized to receive screening laboratory testing or a no-testing approach.” Source: [Shaker et al. (2020)](https://pubmed.ncbi.nlm.nih.gov/31751758/) #### Utility weights for moderate and severe allergic reactions, food allergy, and anaphylaxis, peanut allergy: Shaker et al. (2021) Relevance: Disutility for a transient episode of anaphylaxis, an event that the epinephrine preparedness in section 2 addresses. Access: Not open access Not quoted: The utility weights are reported in the full text, which is closed access. Source: [Shaker et al. (2021)](https://pubmed.ncbi.nlm.nih.gov/33486143/) ## 3 Search strategy | Dataset | Query | Results | | --- | --- | --- | | Ratios | bezuclastinib OR "CGT9486" | 0 | | Ratios | mastocytosis OR "mast cell" | 0 | | Weights | mastocytosis OR "mast cell" | 0 | | Methods | mastocytosis OR avapritinib OR midostaurin | 4 | | Ratios | avapritinib OR midostaurin | 2 | | Ratios | omalizumab AND urticaria | 7 | | Ratios | "venom immunotherapy" OR (venom AND immunotherapy) OR "epinephrine auto-injector" OR anaphylaxis | 19 | | Ratios | ("gastrointestinal stromal" OR GIST) AND (imatinib OR ripretinib OR avapritinib OR sunitinib OR regorafenib) | 22 | | Weights | anaphylaxis OR "anaphylactic" | 42 | ## Related pages - [Bezuclastinib: Nonadvanced systemic mastocytosis](https://www.evicenter.com/drugs/bezuclastinib--nonadvanced-systemic-mastocytosis) · [Markdown](https://www.evicenter.com/drugs/bezuclastinib--nonadvanced-systemic-mastocytosis.md) - [Bezuclastinib in Nonadvanced systemic mastocytosis: Terms and abbreviations](https://www.evicenter.com/drugs/bezuclastinib--nonadvanced-systemic-mastocytosis/terms-and-abbreviations) · [Markdown](https://www.evicenter.com/drugs/bezuclastinib--nonadvanced-systemic-mastocytosis/terms-and-abbreviations.md) - [Bezuclastinib: Nonadvanced systemic mastocytosis](https://www.evicenter.com/drugs/bezuclastinib--nonadvanced-systemic-mastocytosis/executive-summary) · [Markdown](https://www.evicenter.com/drugs/bezuclastinib--nonadvanced-systemic-mastocytosis/executive-summary.md) - [Bezuclastinib in Nonadvanced systemic mastocytosis: Product information and disease description](https://www.evicenter.com/drugs/bezuclastinib--nonadvanced-systemic-mastocytosis/product-information-and-disease-description) · [Markdown](https://www.evicenter.com/drugs/bezuclastinib--nonadvanced-systemic-mastocytosis/product-information-and-disease-description.md) - [Bezuclastinib in Nonadvanced systemic mastocytosis: Clinical evidence](https://www.evicenter.com/drugs/bezuclastinib--nonadvanced-systemic-mastocytosis/clinical-evidence) · [Markdown](https://www.evicenter.com/drugs/bezuclastinib--nonadvanced-systemic-mastocytosis/clinical-evidence.md) - [Bezuclastinib in Nonadvanced systemic mastocytosis: Economic information and modeling report](https://www.evicenter.com/drugs/bezuclastinib--nonadvanced-systemic-mastocytosis/economics) · [Markdown](https://www.evicenter.com/drugs/bezuclastinib--nonadvanced-systemic-mastocytosis/economics.md) - [Bezuclastinib in Nonadvanced systemic mastocytosis: References](https://www.evicenter.com/drugs/bezuclastinib--nonadvanced-systemic-mastocytosis/references) · [Markdown](https://www.evicenter.com/drugs/bezuclastinib--nonadvanced-systemic-mastocytosis/references.md) - [Bezuclastinib in Nonadvanced systemic mastocytosis: prevalence by geography](https://www.evicenter.com/drugs/bezuclastinib--nonadvanced-systemic-mastocytosis/prevalence) · [Markdown](https://www.evicenter.com/drugs/bezuclastinib--nonadvanced-systemic-mastocytosis/prevalence.md)