Section 5 of 6
Economic information and modeling report
13 evidence topics · 5 sources
Modeling overview
Summary
The Irish lifetime cost-effectiveness model projected lower costs and more QALYs than dialysis, while its separate five-year budget analysis projected additional expenditure. The Irish conference poster reported lower costs and additional QALYs in 94.5% of model simulations, but identified the absence of utility data specific to highly sensitized patients with ESRD.
Scotland's acceptance was conditional on a Patient Access Scheme arrangement. France assigned CAV III for clinical added value, but its economic assessment did not establish cost-effectiveness because of major uncertainty and a methodological reservation. These findings concern different jurisdictions and assessment frameworks.
Irish economic model: model structure
Scottish health technology assessment: recommendation and access arrangement
French health technology assessment: clinical added value
French health technology assessment: economic uncertainty
Budget impact model
Approach and framework
Irish submission: budget model
Perspective and time frame
Assessment commissioner and budget horizon
| Characteristic | Quoted record |
|---|---|
| Assessment commissioner | “Health Service Executive (HSE)” |
| Budget horizon | “5 year” |
Epidemiology and eligible population inputs
Cost assumptions
Repeat dosing and average drug costs
| Input | Quoted value |
|---|---|
| Patients receiving a second dose | “6.5%” |
| Mean drug cost before rebate, excluding VAT | “€331,183” |
| Mean drug cost after rebate, excluding VAT | “€303,032” |
Model outcomes
Drug expenditure and overall healthcare expenditure
| Outcome category | Quoted outcome |
|---|---|
| Drug expenditure | “gross drug budget impact” |
| Overall healthcare expenditure | “net budget impact” |
Results
Base case
Five-year Irish budget impact
| Outcome | Quoted amount |
|---|---|
| Gross drug expenditure | “€8,721,695” |
| Net total expenditure, including other healthcare costs and dialysis offsets | “€5,376,092” |
Scenario analyses
No evidence found.
Budget impact model discussion
Summary
The five-year estimate remains an additional cost after dialysis offsets. Inputs include 20 eligible patients, four to five transplants annually, and a 6.5% second-dose rate. The model uses Irish prices and rebates. Its lifetime cost-effectiveness result should not be interpreted as a five-year budget saving.