Pharmacoeconomic review report: Cyclosporine (Verkazia) (Santen Canada inc.) indication: treatment of severe vernal keratoconjunctivitis in children from four years of age through adolescence
The key clinical outcome in the model was the Quality of Life in Children with Vernal Keratoconjunctivitis (QUICK) questionnaire score. Specifically, patients in the symptomatic health state accrued treatment-specific utility decrements based on mapping QUICK questionnaire VKC symptoms domain scores...
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| Format: | eBook |
| Language: | English |
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Ottawa (ON)
Canadian Agency for Drugs and Technologies in Health
2020, January 2020
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| Edition: | Version: final |
| Series: | CADTH common drug review
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| Online Access: | |
| Collection: | National Center for Biotechnology Information - Collection details see MPG.ReNa |
| Summary: | The key clinical outcome in the model was the Quality of Life in Children with Vernal Keratoconjunctivitis (QUICK) questionnaire score. Specifically, patients in the symptomatic health state accrued treatment-specific utility decrements based on mapping QUICK questionnaire VKC symptoms domain scores and daily activities domain scores as reported in the VErnal KeratoconjunctiviTIs Study (VEKTIS); a disutility was also associated with glaucoma. Direct medical costs were estimated from Canadian sources with the use of corticosteroids and eye drops based on the VEKTIS trial. In the manufacturer's base case, cyclosporine 0.1% plus SOC was associated with an incremental cost-utility ratio (ICUR) of $85,003 per QALY gained when compared with SOC alone. At a willingness-to-pay threshold of $50,000 per QALY, cyclosporine 0.1% plus SOC had a 0.03% probability of being cost-effective compared with SOC alone SOC was defined as corticosteroid eye drop rescue medication and the use of over-the-counter lubricant eye drops. The analysis was conducted from the perspective of a Canadian publicly funded health care payer, with both costs and quality-adjusted life-years (QALYs) discounted at a rate of 1.5% per annum over a nine-year time horizon (i.e., until patients reached the end of adolescence, defined as 18 years of age). The model structure was a Markov state transition model with three health states: symptomatic, asymptomatic, and death. Among the modelled patients, 55.4% were assumed to have perennial VKC and remained in the symptomatic health state; the remaining patients (with seasonal VKC) alternated between the symptomatic and asymptomatic health states every six months.3 Patients had a monthly baseline risk of death. In the symptomatic health state, a constant proportion of patients were assumed to have treatment-emergent glaucoma. Cyclosporine (Verkazia) is a topical ophthalmic emulsion (0.1% weight by volume) indicated for the treatment of severe vernal keratoconjunctivitis (VKC) in children from four years of age through adolescence. Cyclosporine 0.1% is supplied as 30 single-use containers containing 0.3 mL unpreserved emulsion at a price of $110.1 The recommended dose is four drops daily in each affected eye. The dose can be reduced to one drop twice daily once adequate control of signs and symptoms is achieved. According to the clinical expert consulted by CADTH, the treatment is administered in response to VKC symptoms, which may be seasonal. At the submitted price, cyclosporine 0.1% would cost $14.68 daily assuming dosing at four separate times each day. The manufacturer submitted a cost-utility analysis of cyclosporine 0.1% plus standard of care (SOC) compared with SOC in pediatric patients with VKC. |
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| Physical Description: | 1 PDF file (31 pages) illustrations |