title: Budget impact of pasireotide LAR for the treatment of acromegaly, a rare endocrine disorder.
abstract: BACKGROUND
  Acromegaly is a rare disorder characterized by the over-production of growth hormone (GH). Patients often experience a range of chronic comorbidities including hypertension, cardiac dysfunction, diabetes, osteoarthropathy, and obstructive sleep apnea. Untreated or inadequately controlled patients incur substantial healthcare costs, while normalization of GH levels may reduce morbidity and mortality rates to be comparable to the general population.
  
  
  OBJECTIVE
  To assess the 3-year budget impact of pasireotide LAR on a US managed care health plan following pasireotide LAR availability.
  
  
  METHODS
  Two separate economic models were developed: one from the perspective of an entire health plan and another from the perspective of a pharmacy budget. The total budget impact model includes costs of drug therapies and other costs for treatment, monitoring, management of adverse events, and comorbidities. The pharmacy cost calculator only considers drug costs.
  
  
  RESULTS
  The total estimated budget impact associated with the introduction of pasireotide LAR is 0.31 cents ($0.0031) per member per month (PMPM) in the first year, 0.78 cents ($0.0078) in the second year, and 1.42 cents ($0.0142) in the third year following FDA approval. Costs were similar or lower from a pharmacy budget impact perspective. For each patient achieving disease control, cost savings from reduced comorbidities amounted to $10,240 per year.
  
  
  CONCLUSIONS
  Published data on comorbidities for acromegaly are limited. In the absence of data on acromegaly-related costs for some comorbidities, comorbidity costs for the general population were used (may be under-estimates).
  
  
  CONCLUSIONS
  The budget impact of pasireotide LAR is expected to be modest, with an expected increase of 1.42 cents PMPM on the total health plan budget in the third year after FDA approval. The efficacy of pasireotide LAR in acromegaly, as demonstrated in head-to-head trials compared with currently available treatment options, is expected to be associated with a reduction of the prevalence of comorbidities.
authors.affiliation: a a Analysis Group, Inc. , Menlo Park , CA , USA.
authors.forename: J J
authors.initials: JJ
authors.lastname: Zhang
authors.affiliation: a a Analysis Group, Inc. , Menlo Park , CA , USA.
authors.forename: D
authors.initials: D
authors.lastname: Nellesen
authors.affiliation: b b Novartis Pharmaceuticals Corporation , East Hanover , NJ , USA.
authors.forename: W H
authors.initials: WH
authors.lastname: Ludlam
authors.affiliation: b b Novartis Pharmaceuticals Corporation , East Hanover , NJ , USA.
authors.forename: M P
authors.initials: MP
authors.lastname: Neary
mesh_terms: D000172:Acromegaly / Q000150:complications / Q000188:drug therapy*; D002017:Budgets; D015897:Comorbidity; D005252:Fees, Pharmaceutical / Q000706:statistics & numerical data*; D006728:Hormones / Q000191:economics* / Q000627:therapeutic use; D006801:Humans; D017059:Models, Econometric; D018803:Models, Economic; D035583:Rare Diseases / Q000150:complications / Q000188:drug therapy*; D013004:Somatostatin / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use
chemical_list: D006728:Hormones; D013004:Somatostatin; C517782:pasireotide
keywords: Acromegaly; Budget-impact; Orphan disease