EVERSANA (Canada)

Chronic kidney disease (CKD) is a leading cause of global morbidity and mortality, affecting one in ten Swiss adults. Patient numbers are expected to increase due to demographic shift and increasing comorbidity rates, necessitating strategic healthcare planning. Holistic burden remains unknown and detailed projections-including expectations of prospective economic and environmental impact-are lacking. To inform Switzerland's public health strategies and support its 2050 net-zero healthcare goal, this study aims to forecast the multidimensional burdens of CKD. The IMPACT-CKD microsimulation model was utilised to project CKD-progression and clinical, healthcare resource utilisation, economic, societal, and environmental outcomes in Switzerland over 10years (2023-2032). Modelled individuals were assigned CKD-relevant characteristics-including kidney function, comorbidities and clinical events-based on real-world data. Individuals were categorised into non-CKD or one of six CKD stages and progressed through the disease, diagnosed or undiagnosed. Model inputs and outcomes were validated and calibrated against literature, real-world evidence, and expert consultation. By 2032, IMPACT-CKD projects Switzerland's cases of CKD to rise by 6.7% (0.96m to 1.03m) with late-stage CKD and kidney replacement therapy (KRT) surging by 18.1% (437k to 516k) and 57.2% (8.4k to 13.2k). CKD-related healthcare costs are projected to increase by 27.6% (Swiss francs [CHF] 3.3b to CHF4.2b), driven by a 77.3% rise KRT-related costs. CKD would account for 4.6% of the Swiss healthcare budget, incur CHF12.9b in lost productivity, 43.2m missed workdays and CHF606m in lost tax revenue. Greenhouse gas emissions are projected to increase by 12.9%, driven by rising dialysis demand. IMPACT-CKD projects substantial increases in the multidimensional burdens of CKD in Switzerland. Impact could be mitigated via earlier detection and broader uptake of guideline-directed medical therapy. Comprehensive health policies and strategic public health planning are necessary to reduce burden and sustain Switzerland's 2050 net-zero healthcare ambition.

PurposeThiotepa is an intravenous alkylating agent used with other chemotherapy drugs to treat several forms of cancers. Preparation of thiotepa requires reconstitution of powder in sterile water, followed by dilution of the solution with sodium chloride 0.9% solution for injection. The reconstitution of lyophilized powdered drug formulations may pose challenges as it can increase the risk of preparation errors, leading to wastage or potential clinical consequences, and extend preparation time compared to ready-to-dilute formulations; one study found that 15% of thiotepa doses were made out-of-tolerance. Tepylute® is a ready-to-dilute formulation of thiotepa and has been approved by the United States Food and Drug Administration for the treatment of breast and ovarian adenocarcinoma. The objective of this study was to explore the economic impact to a hospital pharmacy of using ready-to-dilute Tepylute® versus a lyophilized powdered formulation of thiotepa.Patients and MethodsA cost offset model was created in Microsoft Excel™, the analysis compared a current scenario (thiotepa: 100% market share) with a future scenario (Tepylute®: 100% market share) for a hospital pharmacy treating 96 cancer patients annually. Costs (2024 USD) included drug acquisition, compounding time, drug wastage, and clinical consequences due to reconstitution errors. Incremental costs, cost offsets, and pharmacy time saved were evaluated.ResultsFor a hypothetical hospital pharmacy, use of Tepylute® versus a lyophilized powdered formulation of thiotepa resulted in savings of $339,777 over 1-year ($3539 per patient), primarily from reduced drug acquisition costs, as well as a reduction in drug wastage, clinical consequences due to reconstitution errors, and compounding time. Results were consistent across sensitivity and scenario analyses.ConclusionModeled results demonstrate that ready-to-dilute Tepylute® may save time, reduce acquisition and preparation costs, and lower clinical risks from preparation errors. This study is among the first to quantify potential savings from switching to a ready-to-dilute formulation.

Introduction: The therapeutic landscape for patients with R/R FL is evolving. Lisocabtagene maraleucel (liso-cel), an autologous, CD19-directed, 4-1BB CAR T cell product, and epcoritamab, a T-cell–engaging bispecific antibody, are approved for treatment of patients with third-line or later (3L+) R/R FL in various markets. In the absence of head-to-head data, we conducted an unanchored matching-adjusted indirect comparison (MAIC) to compare the efficacy and safety of liso-cel and epcoritamab in patients with 3L+ R/R FL. Methods: MAICs estimated population-adjusted relative treatment effects for liso-cel (TRANSCEND FL [NCT04245839]; data cutoff for independent review committee [IRC]–assessed outcomes and safety was January 10, 2024; median follow-up, 30.0 mo) and epcoritamab (EPCORE NHL-1 [NCT03625037]; data cutoffs were April 21, 2023 [IRC-assessed outcomes], and January 8, 2024 [safety]; median follow-up, 17.4 mo and 5.7 mo, respectively). The leukapheresed ITT set (N = 114) from TRANSCEND FL and the pivotal cohort (N = 128) from EPCORE NHL-1 were used to compare ORR, CR rate, duration of response (DOR), PFS, and OS. The treated set (N = 107) from TRANSCEND FL and the Cycle 1 optimization cohort (N = 86) from EPCORE NHL-1 were used to compare any-grade cytokine release syndrome (CRS) and corticosteroid or tocilizumab use for CRS. Due to absence of reported infections as a class and no events of neurotoxicity and grade ≥ 3 CRS with epcoritamab, an MAIC for these outcomes was not possible. Baseline characteristics and outcomes in TRANSCEND FL were redefined to align with EPCORE NHL-1. TRANSCEND FL patient data were weighted using a method-of-moments propensity score model to match the marginal distribution of clinical factors among patients from EPCORE NHL-1. Response ratios (RR), HRs, and odds ratios (OR) were used to compare response, time-to-event, and safety outcomes, respectively. Results: Liso-cel was associated with a significantly higher ORR (RR, 1.13; 95% CI: 1.01–1.26) and CR rate (RR, 1.45; 95% CI: 1.17–1.80) compared with epcoritamab. Liso-cel also demonstrated significantly better DOR (HR, 0.41; 95% CI: 0.23–0.73), PFS (HR, 0.33; 95% CI: 0.20–0.53), and OS (HR, 0.33; 95% CI: 0.17–0.66) (Figure). Liso-cel had a numerically higher incidence of any-grade CRS (OR, 1.55; 95% CI: 0.83–2.88) and higher tocilizumab use (OR, 1.71; 95% CI: 0.72–4.09) for CRS management. Corticosteroid use (OR, 0.10; 95% CI: 0.02–0.49) for CRS management was significantly lower for liso-cel. Conclusion: Liso-cel demonstrated significantly better efficacy compared with epcoritamab. Limited safety outcomes could be compared. Overall, the data support liso-cel as an effective treatment for patients with 3L+ R/R FL, potentially offering improved outcomes over epcoritamab in this setting. Research funding declaration: This study was funded by Bristol Myers Squibb. All authors contributed to and approved the abstract; writing and editorial assistance were provided by Maureen Wallace-Nadolski, PhD, CMPP, of The Lockwood Group (Stamford, CT, USA), funded by Bristol Myers Squibb. Keywords: non-Hodgkin; cellular therapies; indolent non-Hodgkin lymphoma Potential sources of conflict of interest: S. Dahiya Consultant or advisory role: Kite pharma, BMS, adaptive biotechnologies Other remuneration: Research funding: Kite pharma, Kyverna Therapeutics J. Kumar Employment or leadership position: Bristol Myers Squibb Stock ownership: Bristol Myers Squibb P. Wang Employment or leadership position: Eversana Consultant or advisory role: Bristol Myers Squibb Other remuneration: Uncompensated Relationship: Eversana M. West Employment or leadership position: Employee of CRG-EVERSANA Consultant or advisory role: Paid consultant to the study sponsor, Bristol Myers Squibb, for development of analysis and related publications A. Jenkins Employment or leadership position: Employee of EVERSANA, which received funding from Bristol Myers Squibb to conduct this research M. Bar Employment or leadership position: Bristol Myers Squibb Stock ownership: Bristol Myers Squibb M. Strocchia Employment or leadership position: Bristol Myers Squibb Stock ownership: Bristol Myers Squibb L. Nastoupil Employment or leadership position: Research support and honorarium for advisory committee participation: BMS Honoraria: Honorarium: AstraZeneca, Regeneron, Merck; Research Support Honorarium: Daiichi Sankyo, Genentech, Gilead/Kite, Janssen, Incyte, Novartis, Takeda

For people living with diabetes, effective glucose monitoring is a key component in diabetes care, helping to reduce disease burden, complications, and healthcare utilization. Sensor-based glucose monitoring systems, which can provide more comprehensive information about glucose levels than capillary-based self-monitoring of blood glucose (SMBG), are becoming established among people living with diabetes. The objective of this study was to assess the cost-effectiveness of glucose monitoring with FreeStyle Libre systems, compared with SMBG, from the perspective of a Canadian private payer. The analysis used the validated, person-level microsimulation model DEDUCE (Determination of Diabetes Utilities, Costs, and Effects). Analyses were conducted separately for populations of people with type 1 and type 2 diabetes mellitus (T1DM; T2DM), with time horizons of 40 and 25years, respectively. T2DM treatment was assumed to be 84% non-insulin, 10% basal insulin, and 6% multiple daily injections of insulin. The effect of FreeStyle Libre was modeled as reductions versus SMBG in glycated hemoglobin level (T1DM, - 0.42%; insulin-treated T2DM, - 0.59%; non-insulin-treated T2DM, - 0.3%) and in acute diabetic events (hypoglycemia and diabetic ketoacidosis). Costs (in 2023Canadian dollars (Can$)) and utilities were discounted at 1.5%. Outcomes were assessed as costs andquality-adjusted life years (QALYs). In both populations, FreeStyle Libre was dominant to SMBG, providing more QALYs at a lower cost (T1DM: + 1.25 QALYs, - Can$32,287 costs; T2DM: + 0.48 QALYs, - Can$8091 costs). Reductions were seen in the cumulative incidence of all complications (except blindness in the T1DM analysis). FreeStyle Libre was dominant to SMBG in all scenarios tested. Probabilistic sensitivity analysis showed that FreeStyle Libre had a 100% probability of being dominant to SMBG for T1DM and a 91% probability of being dominant for T2DM. This economic analysis shows that, from a Canadian private payer perspective, FreeStyle Libre is cost-effective compared with SMBG for all people living with diabetes.