Cost Comparison Table

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Pharmacoeconomic Report: Satralizumab (Enspryng): (Hoffmann-La Roche Limited): Indication: Neuromyelitis optica spectrum disorder [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2021 Jun.

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Pharmacoeconomic Report: Satralizumab (Enspryng): (Hoffmann-La Roche Limited): Indication: Neuromyelitis optica spectrum disorder [Internet].

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Appendix 1Cost Comparison Table

The comparators presented in Table 11 have been deemed to be appropriate based on feedback from clinical expert(s). Comparators may be recommended (appropriate) practice or actual practice. Existing Product Listing Agreements are not reflected in the table and, as such, the table may not represent the actual costs to public drug plans.

Table 11CADTH Cost Comparison Table for Drugs Indicated for the Treatment of NMOSD

Treatment

Strength

Form

Price

Recommended dosage

Average daily drug cost ($)

Average annual drug cost ($)

Satralizumab (Enspryng)

120 mg/mL

Single-use pre-filled syringe

$9,450.0000

120 mg subcutaneously at weeks 0, 2, 4 for the first 3 administrations, followed by 120 mg every 4 weeks thereafter

Year 1:

362.47

Thereafter:

336.58

Year 1:

132,300

Thereafter:

122,850

Eculizumab (Soliris)

10 mg/mL

Vial for IV infusion

$6,742.0000

900 mg weekly for first 4 weeks, followed by 1,200 mg for fifth dose 1 week later, then 1,200 mg every 2 weeks thereafter

Year 1:

1,994.89

Thereafter:

1,921.01

Year 1:

728,136

Thereafter:

701,168

: NMOSD = neuromyelitis optica spectrum disorder.

Table 12CADTH Cost Comparison Table for Other Drugs Used for the Treatment of NMOSD (Not Indicated)

Treatment	Strength	Form	Price ($)	Recommended dosage	Average daily drug cost ($)	Average annual drug cost ($)
Rituximab (Rituxan)	10 mg/mL 100 mg/10 mL 500 mg/50 mL 1,400 mg/11.7 mL 1,600 mg/13.4 mL	Vial for IV infusion	48.2305^a 337.6135 1,688.0780 198.9867^b 195.6485^b	375 mg/m²/week	28.43	10,173^c
Tocilizumab (Actemra)	20 mg/mL (4 mL) 20 mg/mL (10 mL) 20 mg/mL (20 mL) 162 mg/0.9 mL	Vial for IV infusion	182.8000^a 457.0000^a 914.0000^a 358.09050^a	8 mg/kg every month^d	504.83	184,262^c
Azathioprine (generic)	50 mg	Tablet	0.2405	2 to 3 mg/kg^e	0.67 to 1.01	246 to 369
Bortezomib (generic, Velcade)	3.5 mg 10 mL	Single-use vial for SC	186.9457^b 400.6914^b	cycles; 1 mg/m² on days 1, 4, 8, and 11 per cycle^f followed by 10-day treatment-free interval	35.61	(4 cycles, 84 days) 2,991^c
Cyclophosphamide (Procytox)	25 mg 50 mg	Tablet	0.3520 0.4740	1,000 mg/m² every 6 months^g^,^h	0.09	32.23
Cyclophosphamide (Procytox)	200 mg/mL 500 mg/mL 1,000 mg/mL 2,000 mg/mL	Solution	0.6163ⁱ 84.5500^b 123.5200^b 217.4700^b	1,000 mg/m² every 6 months^g^,^h	0.03	11.09
Cyclosporine (generic)	10 mg 25 mg 50 mg 100 mg	Capsule	0.6520 0.9952 1.9400 3.8815	150 mg/day^j	5.82	2,125
Methotrexate (generic)	2.5 mg	Tablet	0.6325	Initiation: 7.5 mg weekly Maintenance: 7.5 to 15 mg weekly^d	Initiation: 0.27 Maintenance: 0.27 to 0.54	Initiation: 99 Maintenance: 99 to 198
Methotrexate (generic)	50 mg/2 mL 20 mg/2 mL 10 mg/0.2 mL 12.5 mg/0.25 mL 17.5 mg/0.35 mL 15 mg/0.3 mL 20 mg/0.4 mL 22.5 mg/0.45 mL	Solution	8.9200 12.5000 29.6400 31.2000 32.0000 32.7600 35.0000 35.0000		Initiation: 0.19 Maintenance: 0.19 to 0.38	Initiation: 70 Maintenance: 70 to 140
Mitoxantrone (generic)	2 mg/mL	Vial	63.0370^b	Initiation:12 mg/m² every 3 to 6 months^d^,^h Maintenance: 6 mg/m² to 12 mg/m² every 3 months^d	Initiation: 7.60 to 19.26 Maintenance: 4.14 to 19.26	Initiation: 1,387 to 2,774 Maintenance: 1,513 to 2,774
Mycophenolate mofetil (generic, Cellcept)	250 mg 500 mg	Capsule	0.3712 0.7423	1,000 mg to 2,000 mg per day^k	1.48 to 2.97	541 to 1,084
Mycophenolate mofetil (generic, Cellcept)	200 mg/mL	Solution	1.8644^b	1,000 mg to 2,000 mg per day^k	9.32 to 18.64	3,403 to 6,805
Prednisone (generic, Winpred 1 mg tablet)	1 mg 5 mg 50 mg	Tablet	0.1066 0.0220 0.1735	1 mg/kg^j daily until taper^k	0.26	95

: NMOSD = neuromyelitis optica spectrum disorder; SC = subcutaneous.
: Note: All prices are from the Ontario Drug Benefit Formulary (accessed March 19, 2020) unless otherwise indicated and do not include dispensing fees.
a: Saskatchewan Drug Formulary.
b: DeltaPA.
c: Assumes drug wastage.
d: Based on a study by Sherman et al. (2015){Sherman, 2015 #84}.
e: Assumes an average adult body weight of 70 kg.
f: Based on a study by Zhang et al. (2017){Zhang, 2017 #86}.
g: Based on personal communication with CADTH clinical experts consulted for this review.
h: Assumes a standard body surface area of 1.7 m² for adults.
i: IQVIA DeltaPA (British Columbia formulary){REF: DeltaPA database}.
j: Based on a study by Kageyama et al. (2013){Kageyama, 2013 #85}.
k: Based on a study by Xu et al. (2016); adult dosage{Xu, 2016 #87}.

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Pharmacoeconomic Report: Satralizumab (Enspryng): (Hoffmann-La Roche Limited): Indication: Neuromyelitis optica spectrum disorder [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2021 Jun. Appendix 1, Cost Comparison Table.
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