Pharmacoeconomic review report. Daclizumab (Zinbryta).
Daclizumab beta (Zinbryta, DAC) is a humanized, monoclonal antibody directed against the interleukin-2 receptor. DAC beta is indicated for the treatment of adult patients with active relapsing-remitting multiple sclerosis (RRMS) who have had an inadequate response to, or who are unable to tolerate,...
Saved in:
| Online Access: |
http://www.ncbi.nlm.nih.gov/books/NBK535198/ Full text |
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| Format: | Electronic eBook |
| Language: | English |
| Published: |
[Ottawa, Ontario] :
Canadian Agency for Drugs and Technologies in Health,
2017
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| Series: | Common drug review clinical review report.
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| Subjects: |
| Summary: | Daclizumab beta (Zinbryta, DAC) is a humanized, monoclonal antibody directed against the interleukin-2 receptor. DAC beta is indicated for the treatment of adult patients with active relapsing-remitting multiple sclerosis (RRMS) who have had an inadequate response to, or who are unable to tolerate, one or more therapies indicated for the treatment of multiple sclerosis (MS). DAC is available as a pre-filled syringe or pen solution for subcutaneous injection (150 mg per 1 mL). At a recommended dose of 150 mg subcutaneous once monthly and a manufacturer-submitted market price of $2,308 per 150 mg pre-filled pen or syringe, DAC costs $7,700 per year. The manufacturer's listing request is per the Health Canada indication. The manufacturer submitted a cost-utility analysis based on a Markov state-transition model comparing DAC with fingolimod for the treatment of adult patients with RRMS. Further comparisons were made against different interferon (IFN) beta-1 formulations (Avonex, Betaferon, Extavia, Rebif 44), biologics (alemtuzumab, natalizumab), and other injectable and oral disease-modifying therapies (DMTs: glatiramer acetate, dimethyl fumarate, and teriflunomide). Patients transitioned between different Kurzke Expanded Disability Status Scale (EDSS) levels (0 to 9) and could progress from RRMS to secondary-progressive MS (SPMS). The analysis used a 25-year horizon and was undertaken from the public health care payer perspective. Data on baseline disease progression and relapses were derived from the placebo arm of the pivotal SELECT trial, the British Columbia MS database, London Ontario database, and UK MS Survey. The effects of treatment on disease progression and relapse rates were derived from a manufacturer-commissioned mixed treatment comparison. The manufacturer reported that DAC dominated fingolimod as it produced more quality-adjusted life-years (QALYs) and costs less. When compared with all treatments, DAC was dominated by alemtuzumab. DAC was more effective and more costly than all IFNs, glatiramer, dimethyl fumarate, and teriflunomide. The incremental cost per QALY gained for DAC in each of these comparisons was greater than 0,000 (range: $4,565 to $74,026). Natalizumab was more costly and more effective than DAC; no incremental cost per QALY gained was reported by the manufacturer. |
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| Physical Description: | 1 online resource (1 PDF file (iii, 23 pages)) : illustration. |
| Bibliography: | Includes bibliographical references. |
| Source of Description, Etc. Note: | Description based on online resource; title from PDF title page (viewed March 5, 2019). |
