Full Papers
Cost effectiveness of avacopan for ANCA-associated vasculitis in China
Y. Jiang1, H. Shao2, W. Tang3
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, Jiangsu; and Center for Pharmacoeconomics and Outcomes Research, Department of Public Affairs Management, School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, Jiangsu, China.
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, Jiangsu; and Center for Pharmacoeconomics and Outcomes Research, Department of Public Affairs Management, School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, Jiangsu, China.
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, Jiangsu; and Center for Pharmacoeconomics and Outcomes Research, Department of Public Affairs Management, School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, Jiangsu, China. tokammy@cpu.edu.cn
CER19524
Full Papers
PMID: 41841661 [PubMed]
Received: 13/11/2025
Accepted : 19/12/2025
In Press: 13/03/2026
Abstract
OBJECTIVES:
To evaluate the cost-effectiveness of avacopan plus immunosuppressants versus glucocorticoid (GC)-based regimens for adults with granulomatosis with polyangiitis (GPA) or microscopic polyangiitis (MPA) in China, and to estimate the maximum avacopan unit price consistent with willingness-to-pay (WTP) thresholds.
METHODS:
A nine-state Markov model (active disease; three remission states; three relapse states; end-stage renal disease [ESRD]; death) was developed from the Chinese healthcare system perspective. Baseline characteristics were derived from the ADVOCATE trial. The intervention was avacopan plus cyclophosphamide (CYC) or rituximab (RTX) with reduced-dose GCs; the comparator was CYC/RTX plus standard GCs. Treatment shares followed trial allocation (35.2% CYC; 64.8% RTX). Outcomes included total costs, life-years (LYs), quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs), using a WTP threshold of one time China’s 2024 GDP per capita per QALY. Uncertainty was assessed through one-way, probabilistic, and scenario analyses. Threshold price analyses back calculated the avacopan unit price at WTPs of one time, 1.2 times, and 1.5 times GDP per capita.
RESULTS:
Avacopan increased QALYs (5.81 vs. 5.26) and LYs (8.25 vs. 7.77) and increased total costs ($73,478 vs. $70,110), yielding an ICER of $6,146/QALY. At a WTP of $13,445/QALY, avacopan was cost-effective; results were robust in sensitivity and scenario analyses. The maximum cost-effective price was $11.12-$12.70 per 10 mg at WTPs of 1.0-1.5 times GDP per capita.
CONCLUSIONS:
Avacopan-based regimens are cost-effective versus GC-based therapy for GPA/MPA in China and support value-based pricing of $11.12-$12.70 per 10 mg.
