Display options
Share it on

Pharmacoecon Open. 2019 Dec;3(4):479-493. doi: 10.1007/s41669-019-0142-3.

A Systematic Review of the Health Economics of Pompe Disease.

PharmacoEconomics - open

Benedikt Schoser, Andreas Hahn, Emma James, Digant Gupta, Matthew Gitlin, Suyash Prasad

Affiliations

  1. Friedrich-Baur-Institut, Neurologische Klinik, Klinikum der Universität München, Ludwig-Maximilians-University Munich, Munich, Germany. [email protected].
  2. Department of Child Neurology, University of Giessen, Feulgenstrasse 12, 35385, Giessen, Germany.
  3. Audentes Therapeutics, 600 California Street, Floor 17, San Francisco, CA, 94108, USA.
  4. Bridge Medical Consulting Ltd, Gainsborough House, 2 Sheen Road, Richmond, London, UK.
  5. BluePath Solutions, 10951 West Pico Blvd, Suite 120, Los Angeles, CA, 90064, USA.

PMID: 31049836 PMCID: PMC6861413 DOI: 10.1007/s41669-019-0142-3

Abstract

BACKGROUND: Pompe disease is a rare, severe neuromuscular disease with high mortality and substantial clinical and humanistic burden. However, the economic burden of Pompe disease and the health economic value of its treatments are not well understood. The objectives of this systematic review were to characterize the health economic evidence on Pompe disease, including healthcare resource use and costs (direct and indirect), health utilities, and the cost-effectiveness of current treatments used to manage patients with Pompe disease.

METHODS: A systematic search of MEDLINE

RESULTS: Eight publications evaluated patients with infantile-onset Pompe disease (IOPD) (two studies), late-onset Pompe disease (LOPD) (four studies), or both (two studies). In IOPD, total cost of supportive therapy (excluding treatment) was €32,871 (equivalent to US$41,667 when adjusted for currency and inflation to 2017 US dollars) over a life expectancy of 0.4 years. In adult LOPD, the average annual cost per patient of supportive therapy was €22,475 (adjusted $28,489). Resource use in LOPD was high, with nursing home admissions accounting for 19% of annual direct medical costs. Health economic evaluations estimating incremental costs per quality-adjusted life year (QALY) gained with enzyme-replacement therapy (ERT) versus supportive therapy ranged from £109,991 (adjusted, $186,851) per QALY gained in Columbia to €1,043,868 (adjusted, $1,323,207) in the Netherlands.

DISCUSSION: Despite a full systematic literature search, only eight relevant publications were identified, most of which were of relatively poor quality. However, a significant economic burden of Pompe disease on patients, families, healthcare systems, and society was found, with the majority of costs driven by the only currently approved treatment, ERT. Health economic evaluations of ERT versus supportive therapy vary significantly, with the majority well above willingness-to-pay thresholds. New therapies and approaches to care are needed to address the persistent and lifelong economic burden of Pompe disease and the large incremental cost-effectiveness ratios observed.

References

  1. J Neurol. 2017 Apr;264(4):621-630 - PubMed
  2. Muscle Nerve. 2012 Mar;45(3):319-33 - PubMed
  3. Health Technol Assess. 2012;16(39):1-543 - PubMed
  4. Diabetes Care. 2008 Mar;31(3):596-615 - PubMed
  5. Isr J Med Sci. 1988 Apr-May;24(4-5):224-7 - PubMed
  6. Eur J Hum Genet. 1999 Sep;7(6):713-6 - PubMed
  7. PLoS Med. 2009 Jul 21;6(7):e1000097 - PubMed
  8. J Inherit Metab Dis. 2016 May;39(3):383-390 - PubMed
  9. Pediatr Res. 2009 Sep;66(3):329-35 - PubMed
  10. Ther Adv Neurol Disord. 2009 May;2(3):143-53 - PubMed
  11. J Inherit Metab Dis. 1987;10(1):11-7 - PubMed
  12. Orphanet J Rare Dis. 2016 May 04;11(1):58 - PubMed
  13. Pediatr Neonatol. 2013 Aug;54(4):219-27 - PubMed
  14. Rev Salud Publica (Bogota). 2012 Jan-Feb;14(1):143-55 - PubMed
  15. Int J Technol Assess Health Care. 2007 Winter;23(1):36-42 - PubMed
  16. JIMD Rep. 2015;20:65-75 - PubMed
  17. J Inherit Metab Dis. 2015 May;38(3):445-57 - PubMed
  18. Dev Med Child Neurol. 2018 Jun;60(6):579-586 - PubMed
  19. N Engl J Med. 2010 Apr 15;362(15):1396-406 - PubMed
  20. Am Health Drug Benefits. 2012 May;5(3):182-9 - PubMed
  21. J Inherit Metab Dis. 2010 Dec;33(6):747-50 - PubMed
  22. J Inherit Metab Dis. 2011 Oct;34(5):1045-52 - PubMed
  23. Neurol Clin. 2014 Aug;32(3):751-76, ix - PubMed
  24. J Inherit Metab Dis. 2016 Mar;39(2):253-60 - PubMed
  25. Qual Life Res. 2015 Apr;24(4):837-44 - PubMed
  26. S Afr Med J. 2014 Apr;104(4):273-4 - PubMed
  27. J Gen Intern Med. 2014 Aug;29 Suppl 3:S774-9 - PubMed
  28. Orphanet J Rare Dis. 2017 Dec 13;12(1):179 - PubMed
  29. Dev Med Child Neurol. 2018 Jun;60(6):536 - PubMed
  30. Adv Exp Med Biol. 2010;686:273-82 - PubMed
  31. Orphanet J Rare Dis. 2014 May 16;9:75 - PubMed
  32. J Manag Care Spec Pharm. 2014 Nov;20(11):1086-92 - PubMed
  33. Health Econ. 2015 Oct;24(10):1256-1271 - PubMed
  34. BMC Neurol. 2017 Nov 22;17(1):202 - PubMed
  35. Mol Genet Metab. 2013 Aug;109(4):371-6 - PubMed
  36. Muscle Nerve. 2014 Mar;49(3):431-8 - PubMed
  37. J Inherit Metab Dis. 2012 Sep;35(5):837-45 - PubMed
  38. J Neurol. 2010 Jan;257(1):91-7 - PubMed

Publication Types