{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T18:52:44Z","timestamp":1760986364615,"version":"build-2065373602"},"reference-count":69,"publisher":"The Journal of Health Economics and Outcomes Research","issue":"2","license":[{"start":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T00:00:00Z","timestamp":1754438400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["jheor.org"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> Proteinuria, a critical marker of glomerulosclerosis, poses a challenge in idiopathic membranous nephropathy (iMN), particularly when standard treatments fail. Acthar\u00ae Gel, a US Food and Drug Administration\u2013approved treatment option, may offer an alternative for managing refractory proteinuria in nephrotic syndrome (NS) due to iMN where multiple treatments have failed.<\/jats:p> <jats:p><jats:bold>Objective:<\/jats:bold> The cost per response of Acthar\u00ae Gel vs standard of care (SoC; cyclophosphamide or rituximab) for treatment of proteinuria in NS due to iMN was evaluated among adults who had failed multiple treatments from a US payer perspective over a 1- to 3-year horizon.<\/jats:p> <jats:p><jats:bold>Methods:<\/jats:bold> A probabilistic, cohort-level state-transition model simulated patient progression through various health states using 6-month cycles. Patients began in a relapse phase and received either Acthar\u00ae Gel or SoC. Transition probabilities determined whether patients achieved a response, experienced no response, progressed to renal failure, or remained in relapse. Responders could potentially maintain their response or relapse, while nonresponders risked renal failure, with potential mortality from any state. Clinical, healthcare resource utilization, and cost data were derived from published literature. Drug prices were based on wholesale acquisition costs.<\/jats:p> <jats:p><jats:bold>Results:<\/jats:bold> Over 1 year, Acthar\u00ae Gel showed a lower cost per response ($377\u2009185) than cyclophosphamide ($551\u2009687) and rituximab ($741\u2009373). This cost advantage of Acthar\u00ae Gel was maintained over 2 and 3 years. Acthar\u00ae Gel had higher drug acquisition costs than cyclophosphamide and rituximab but resulted in lower overall medical costs and higher response rates within 1 year, without additional treatment-related costs. Over 2 and 3 years, Acthar\u00ae Gel had a lower overall cost of care and higher response rates than SoC, establishing it as a dominant treatment option.<\/jats:p> <jats:p><jats:bold>Conclusions:<\/jats:bold> Based on current model assumptions and clinical inputs, Acthar\u00ae Gel may potentially be a cost-effective and value-based treatment strategy vs unapproved SoCs for adults with refractory proteinuria in NS due to iMN, particularly for those who have not responded to conventional therapies over a 1- to 3-year period within a US payer context. These results may inform clinical and payer decision-making in cases when other standard therapies fail to achieve desired outcomes for a specific population.<\/jats:p>","DOI":"10.36469\/001c.142078","type":"journal-article","created":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T17:09:46Z","timestamp":1754500186000},"update-policy":"https:\/\/doi.org\/10.36469\/00001","source":"Crossref","is-referenced-by-count":0,"title":["Cost per Response of Acthar\u00ae Gel vs Standard of Care for the Treatment of Proteinuria in Nephrotic Syndrome Due to Idiopathic Membranous Nephropathy Among Adults from the US Healthcare Perspective"],"prefix":"10.36469","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0161-4165","authenticated-orcid":true,"given":"Jas","family":"Bindra","sequence":"first","affiliation":[{"name":"Falcon Research Group, North Potomac, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ishveen","family":"Chopra","sequence":"additional","affiliation":[{"name":"Manticore Consultancy, Bethesda, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyle","family":"Hayes","sequence":"additional","affiliation":[{"name":"Mallinckrodt Pharmaceuticals, Bridgewater, New Jersey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Niewoehner","sequence":"additional","affiliation":[{"name":"Mallinckrodt Pharmaceuticals, Bridgewater, New Jersey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary P.","family":"Panaccio","sequence":"additional","affiliation":[{"name":"Mallinckrodt Pharmaceuticals, Bridgewater, New Jersey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George J.","family":"Wan","sequence":"additional","affiliation":[{"name":"Mallinckrodt Pharmaceuticals, Bridgewater, New Jersey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"22273","published-online":{"date-parts":[[2025,8,6]]},"reference":[{"issue":"3","key":"ref1","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1111\/j.1365-4632.2009.04322.x","article-title":"Prevention and treatment of systemic glucocorticoid side effects","volume":"49","author":"S. 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Fingar","year":"2006","journal-title":"Healthcare Cost and Utilization Project (HCUP) Statistical Briefs"},{"issue":"1","key":"ref59","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1002\/clc.22341","article-title":"Hospitalization costs for acute myocardial infarction patients treated with percutaneous coronary intervention in the United States are substantially higher than Medicare payments","volume":"38","author":"M. Afana","year":"2015","journal-title":"Clin Cardiol"},{"key":"ref60","doi-asserted-by":"publisher","DOI":"10.1002\/cpt.3493","article-title":"A systematic review of the costs of drug-associated acute kidney injury and potential cost savings with nephrotoxin stewardship prevention strategies","author":"B. A. Stottlemyer","year":"2024","journal-title":"Clin Pharmacol Ther"},{"article-title":"Overview of outcomes for inpatient stays involving sepsis, 2016-2021","year":"2024","author":"P. L. Owens","key":"ref61"},{"issue":"3","key":"ref62","doi-asserted-by":"publisher","first-page":"454","DOI":"10.1093\/annonc\/mdm525","article-title":"Cost of neutropenic complications of chemotherapy","volume":"19","author":"D. Weycker","year":"2008","journal-title":"Ann Oncol"},{"key":"ref63","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1016\/j.thromres.2015.11.033","article-title":"The economic burden of incident venous thromboembolism in the United States: a review of estimated attributable healthcare costs","volume":"137","author":"S. D. Grosse","year":"2016","journal-title":"Thromb Res"},{"issue":"9","key":"ref64","doi-asserted-by":"publisher","first-page":"846","DOI":"10.1080\/13696998.2018.1474750","article-title":"Healthcare resource use and cost associated with varying dosages of extended corticosteroid exposure in a US population","volume":"21","author":"J. B. 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