Cost-effectiveness of olorofim in the treatment of invasive aspergillosis in patients with limited suitable alternative treatment options: a US payer perspective.

This study aimed to estimate the cost-effectiveness of treating invasive aspergillosis (IA) in patients with limited treatment options with either olorofim or currently available antifungal salvage therapy from a US payer perspective. A hybrid decision tree-Markov model with a one-year time horizon was used to estimate health economic outcomes. The model considered probabilities of treatment response, mortality, and treatment-emergent adverse events; costs of antifungals and healthcare utilization; and patient utility. For olorofim, patient-level data from the open-label, single-arm, Phase IIb study of olorofim for the treatment of proven or probable IA with limited treatment options (Study 32, NCT03583164) was used. Salvage therapy data were based on an external control arm of a study of IA patients. A willingness-to-pay threshold of $50,000/quality-adjusted life-year (QALY) was assumed to assess the cost-effectiveness of olorofim versus salvage therapy. One-year costs (2023 USD) of treating IA in patients with limited alternative options were $208,696 for currently available salvage therapy and $167,971 for olorofim, for an incremental cost reduction of $40,725. QALYs were 0.46 for olorofim and 0.22 for salvage therapy. Olorofim was determined to be a dominant (less costly, more effective) strategy, with an incremental net monetary benefit of $52,827. Olorofim remained the dominant strategy across all sensitivity analyses. Upon probabilistic sensitivity analysis, olorofim was dominant in 90.0% of 1,000 iterations and cost-effective in 97.5%. Olorofim resulted in lower total treatment costs, antifungal costs, and more QALY gains versus currently available salvage therapy, making olorofim the dominant strategy for treating IA with limited treatment options.