The addition of ropeginterferon alfa-2b (ropegIFNα) to phlebotomy for the treatment of polycythemia vera (PV) was “cost effective,” according to an Austrian study led by Evelyn Walter, of IPF Institute for Pharmaeconomic Research in Vienna, and published in Annals of Hematology.

Researchers used a 12-month decision tree and semi-Markov cohort model to compare ropegIFNα plus phlebotomy versus phlebotomy alone in 1,000 hypothetical patients from the Austrian healthcare payer perspective; only direct medical costs were used. Inputs were included from the phase 2 Low-PV study, other published literature, and Austrian-specific cost databases. The model used a 30-year time horizon and assessed quality-adjusted life years (QALYs), costs, and incremental cost-utility ratio (ICUR).

The average total cost per patient

The addition of ropegIFNα resulted in 1.43 higher QALYs (10.09 vs 8.65) compared with phlebotomy alone. The average total cost per patient was €269.883 for ropegIFNα and €218.923 for phlembotomy alone, representing a €50.960 cost difference. The largest cost contributor was drugs in both cohorts (72.4% vs 55.0%). The was ICUR €35.525.

Costs related to thrombosis, myelofibrosis, and acute myeloid leukemia decreased by 12%, 30%, and 16%, respectively, in the ropegIFNα cohort due to the delayed complications onset and disease progression. Phlebotomy does not prevent myelofibrosis, while early ropegIFNα did delay post-PV transition to myelofibrosis, which reduced costs by 30%.

RopegIFNα costs and discount rates appeared to have the greatest impact on results. Probabilistic results showed that ropegIFNα was cost-effective in around “100%” of all simulations using the Austrian gross domestic product as a willingness-to-pay threshold.

In terms of cost-effectiveness, the investigators indicated that the cost-effectiveness of ropegIFNα may vary across European countries due to differences in healthcare system structures, funding, and reimbursement policies. In addition, indirect costs such as time and productivity loss are not reflected in this analysis.

“These findings suggest that early treatment with ropegIFNα could ensure optimal resource allocation by preventing costly thrombotic events and progression to [myelofibrosis] whilst increasing patient quality of life,” the authors concluded.

Reference

Walter E, Torelli F, Barbui T. Cost-utility analysis of ropeginterferon alfa-2b to manage low-risk patients with polycythemia vera as compared to phlebotomy only in the Austrian healthcare system. Ann Hematol. 2025. Epub ahead of print. doi:10.1007/s00277-025-06229-w