Assessing the value of delandistrogene moxeparvovec (SRP-9001) gene therapy in patients with Duchenne muscular dystrophy in the United States

Abstract

ABSTRACTBackground: Delandistrogene moxeparvovec (SRP-9001) is an investigational gene therapy that may delay progression of Duchenne muscular dystrophy (DMD), a severe, rare neuromuscular disease caused by DMD gene mutations. Early cost-effectiveness analyses are important to help contextualize the value of gene therapies for reimbursement decision making.Objective: To determine the potential value of delandistrogene moxeparvovec using a cost-effectiveness analysis.Study design: A simulation calculated lifetime costs and equal value of life years gained (evLYG). Inputs included extrapolated clinical trial results and published utilities/costs. As a market price for delandistrogene moxeparvovec has not been established, threshold analyses established maximum treatment costs as they align with value, including varying willingness-to-pay up to $500,000, accounting for severity/rarity.Setting: USA, healthcare system perspectivePatients: Boys with DMDIntervention: Delandistrogene moxeparvovec plus standard of care (SoC; corticosteroids) versus SoC aloneMain outcome measure: Maximum treatment costs at a given willingness-to-pay thresholdResults: Delandistrogene moxeparvovec added 10.30 discounted (26.40 undiscounted) evLYs. The maximum treatment cost was approximately $5 M, assuming $500,000/evLYG. Varying the benefit discount rate to account for the single administration increased the estimated value to >$5M, assuming $500,000/evLYG.Conclusion: In this early economic model, delandistrogene moxeparvovec increases evLYs versus SoC and begins to inform its potential value from a healthcare perspective.

Keywords

• Cost-effectiveness analysis
• delandistrogene moxeparvovec
• Duchenne muscular dystrophy
• gene therapy
• SRP-9001