{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T21:24:55Z","timestamp":1790630695367,"version":"4.1.0"},"reference-count":0,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T00:00:00Z","timestamp":1761523200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Can. J. Neurol. Sci."],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec id=\"S0317167125104496_as1\">\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Generalized myasthenia gravis (gMG) is a chronic neuromuscular disease that causes muscle weakness and fatigue, severely impairing quality of life. Efgartigimod is a novel drug that is recently approved for treatment of acetylcholine receptor antibody-positive (AChR-Ab+) gMG patients in Canada. In clinical practice, it is expected to be used in AChR-Ab+ gMG patients who continue to experience symptoms despite conventional therapy and primarily replace chronic immunoglobulins.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0317167125104496_as2\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A Markov model was developed to estimate costs and benefits (measured as quality-adjusted life years [QALYs]) of efgartigimod and chronic immunoglobulins for AChR-Ab+ gMG patients. The analysis was conducted from the perspective of the Canadian publicly funded healthcare system over a lifetime horizon. The model comprised six health states based on Myasthenia Gravis Activities of Daily Living (MG-ADL) scores: MG-ADL &lt; 5, MG-ADL 5\u20137, MG-ADL 8\u20139, MG-ADL \u2265 10, myasthenic crisis or death. Health state transition probabilities were estimated from the ADAPT and ADAPT+ studies, plus a network meta-analysis that compared efgartigimod against chronic immunoglobulins. The MyRealWorld MG study informed utility values. Modeled costs included treatment and administration, disease monitoring, complications from chronic corticosteroid use, exacerbation\/crisis management, adverse events and end-of-life care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0317167125104496_as3\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Over a lifetime horizon, efgartigimod and chronic immunoglobulins were predicted to have total discounted QALYs of 16.80 and 13.35 and total discounted costs of $1,913,294 and $2,170,315, respectively. Efgartigimod dominated chronic immunoglobulins\u00a0with incremental QALYs of 3.45 and cost savings of $257,020.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0317167125104496_as4\">\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Efgartigimod provides greater benefit in terms of lower costs than chronic immunoglobulins for AChR-Ab+ gMG patients in Canada.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/cjn.2025.10449","type":"journal-article","created":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T04:31:21Z","timestamp":1761539481000},"page":"1-12","source":"Crossref","is-referenced-by-count":4,"title":["Cost-Effectiveness Analysis of Efgartigimod vs Chronic Immunoglobulin for the Treatment of Myasthenia Gravis in Canada"],"prefix":"10.1017","author":[{"given":"Zaeem A.","family":"Siddiqi","sequence":"first","affiliation":[{"name":"University of Alberta"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia Z.","family":"Qi","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04spfxf63","id-type":"ROR","asserted-by":"publisher"}],"name":"argenx US Inc."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-9862-8492","authenticated-orcid":false,"given":"Allen","family":"Zhou","sequence":"additional","affiliation":[{"name":"CRG-EVERSANA Inc."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger","family":"Kaprielian","sequence":"additional","affiliation":[{"name":"argenx"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Locklin","sequence":"additional","affiliation":[{"name":"argenx"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Garcia","sequence":"additional","affiliation":[{"name":"CRG-EVERSANA Inc."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Hughes","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04spfxf63","id-type":"ROR","asserted-by":"publisher"}],"name":"argenx US Inc."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Genge","sequence":"additional","affiliation":[{"name":"McGill University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2025,10,27]]},"container-title":["Canadian Journal of Neurological Sciences \/ Journal Canadien des Sciences Neurologiques"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0317167125104496","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T08:29:14Z","timestamp":1763022554000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0317167125104496\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,27]]},"references-count":0,"alternative-id":["S0317167125104496"],"URL":"https:\/\/doi.org\/10.1017\/cjn.2025.10449","relation":{},"ISSN":["0317-1671","2057-0155"],"issn-type":[{"value":"0317-1671","type":"print"},{"value":"2057-0155","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,27]]}}}