Cost Consequence Analysis of Belimumab versus Standard of Care for the Management of Systemic Lupus Erythematosus in Saudi Arabia: A Retrospective Cohort Study

Aseel Alsuwayegh, Ibrahim A. Almaghlouth (), Majed Ali Almasaoud, Abdullah Sulaiman Alzaid, Adel Abdulaziz Alsuhaibani, Lyan Hassan Almana, Sara Mohammed Alabdulkareem, Joud Abdullah Abudahesh and Yazed AlRuthia ()
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Aseel Alsuwayegh: Corporate Department of Pharmacy Services, King Saud University Medical City, Riyadh 11451, Saudi Arabia
Ibrahim A. Almaghlouth: Department of Medicine, College of Medicine, King Saud University, Riyadh 11461, Saudi Arabia
Majed Ali Almasaoud: College of Medicine, King Saud University, Riyadh 11461, Saudi Arabia
Abdullah Sulaiman Alzaid: College of Medicine, King Saud University, Riyadh 11461, Saudi Arabia
Adel Abdulaziz Alsuhaibani: College of Medicine, King Saud University, Riyadh 11461, Saudi Arabia
Lyan Hassan Almana: College of Medicine, King Saud University, Riyadh 11461, Saudi Arabia
Sara Mohammed Alabdulkareem: College of Medicine, King Saud University, Riyadh 11461, Saudi Arabia
Joud Abdullah Abudahesh: College of Medicine, King Saud University, Riyadh 11461, Saudi Arabia
Yazed AlRuthia: Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia

IJERPH, 2023, vol. 20, issue 3, 1-10

Abstract: Background: Belimumab use for the management of systemic lupus erythematosus (SLE) has been limited, in part due to its high acquisition cost relative to the standard of care (SoC) and the uncertainties about its cost-effectiveness. Therefore, the aim of this study was to compare the cost and effectiveness of belimumab versus the SoC alone for the management of SLE using real-world data from the perspective of public healthcare payers in Saudi Arabia. Methods: Data were retrieved from a national prospective cohort of SLE, Saudi Arabia. Adult SLE patients (≥18 yrs.) treated with belimumab plus the SoC or the SoC alone for at least six months were recruited. The effectiveness was measured using the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K). Unit costs for health services and prescription drugs were retrieved from the Saudi ministry of health. Nonparametric bootstrapping with inverse probability weighting was conducted to generate the 95% confidence limits for the cost and effectiveness. Results: A total of 15 patients on belimumab plus the SoC and 41 patients on the SoC alone met the inclusion criteria and were included in the analysis. The majority of patients were females (91.07%) with a mean age of 38 years. The mean difference in cost and SLEDAI-2K score reduction between belimumab versus the SoC were USD 5303.16 [95% CI: USD 2735.61–USD 7802.52] and 3.378 [95% CI: 1.769–6.831], respectively. Belimumab demonstrated better effectiveness but higher cost in 96% of the bootstrap cost-effectiveness distributions. Conclusion: Future studies should use more robust research designs and a larger sample size to confirm the findings of this study.

Keywords: systemic lupus erythematosus; belimumab; cost effectiveness analysis; Saudi Arabia; lupus nephritis (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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