Pioneering SMA therapies for all types: survival gains, cost dynamics, and performance-based agreements

Abstract Background The purpose of this study was to assess the impact of survival improvements and performance-based managed entry agreements (PBMEAs) on the cost implications of introducing innovative spinal muscular atrophy (SMA) treatments, nusinersen, onasemnogene abeparvovec, and risdiplam, fo...

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Main Authors: Ahmed Al-jedai, Hajer Al-Mudaiheem, AlJohara AlSakran, Fahad A. Bashiri, Fouad Ghamdi, Mohammad A. Almuhaizea, Abdulaziz AlSamman, Nancy Awad, Rita Ojeil
Format: Article
Language:English
Published: BMC 2025-08-01
Series:Cost Effectiveness and Resource Allocation
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Online Access:https://doi.org/10.1186/s12962-025-00647-3
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author Ahmed Al-jedai
Hajer Al-Mudaiheem
AlJohara AlSakran
Fahad A. Bashiri
Fouad Ghamdi
Mohammad A. Almuhaizea
Abdulaziz AlSamman
Nancy Awad
Rita Ojeil
author_facet Ahmed Al-jedai
Hajer Al-Mudaiheem
AlJohara AlSakran
Fahad A. Bashiri
Fouad Ghamdi
Mohammad A. Almuhaizea
Abdulaziz AlSamman
Nancy Awad
Rita Ojeil
author_sort Ahmed Al-jedai
collection DOAJ
description Abstract Background The purpose of this study was to assess the impact of survival improvements and performance-based managed entry agreements (PBMEAs) on the cost implications of introducing innovative spinal muscular atrophy (SMA) treatments, nusinersen, onasemnogene abeparvovec, and risdiplam, for managing SMA Types 1, 2, and 3 from the perspective of the Saudi Ministry of Health (MoH). Methods A budget impact model was created using inputs such as total population, market share, median survival, and resource utilization obtained through literature review and validated by expert committees. The model projected the overall cost (drug acquisition, administration, and disease management) for best supportive care (BSC) with and without these interventions over a 5-year period using Microsoft Excel as the analytical tool. Results For SMA Type 1, the overall net budget impact of introducing onasemnogene abeparvovec, nusinersen, or risdiplam was significant, ranging from 112 to 225%. The impact was even greater for SMA Type 2 and 3, ranging from 171 to 283% due to high survival rates. However, the budget impact could be mitigated by improved clinical management and PBMEAs, reducing it to 77–84% for Type 1 and 36–117% for Types 2 and 3. Conclusion the introduction of these pioneering interventions for SMA management would raise the overall budget for the payer, primarily due to drug acquisition costs. Nevertheless, this increase could be offset by improvements in clinical management and PBMEAs.
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spelling doaj-art-3629c63552cd4c76a9afcf487f84631c2025-08-20T03:05:24ZengBMCCost Effectiveness and Resource Allocation1478-75472025-08-0123111210.1186/s12962-025-00647-3Pioneering SMA therapies for all types: survival gains, cost dynamics, and performance-based agreementsAhmed Al-jedai0Hajer Al-Mudaiheem1AlJohara AlSakran2Fahad A. Bashiri3Fouad Ghamdi4Mohammad A. Almuhaizea5Abdulaziz AlSamman6Nancy Awad7Rita Ojeil8Colleges of Medicine and Pharmacy, Alfaisal UniversityMinistry of HealthKing Faisal Specialist Hospital and Research CentreKing Saud UniversityKing Fahad Specialist HospitalColleges of Medicine and Pharmacy, Alfaisal UniversityNational Neuroscience Institute, King Fahad Medical CityCarexsoCarexsoAbstract Background The purpose of this study was to assess the impact of survival improvements and performance-based managed entry agreements (PBMEAs) on the cost implications of introducing innovative spinal muscular atrophy (SMA) treatments, nusinersen, onasemnogene abeparvovec, and risdiplam, for managing SMA Types 1, 2, and 3 from the perspective of the Saudi Ministry of Health (MoH). Methods A budget impact model was created using inputs such as total population, market share, median survival, and resource utilization obtained through literature review and validated by expert committees. The model projected the overall cost (drug acquisition, administration, and disease management) for best supportive care (BSC) with and without these interventions over a 5-year period using Microsoft Excel as the analytical tool. Results For SMA Type 1, the overall net budget impact of introducing onasemnogene abeparvovec, nusinersen, or risdiplam was significant, ranging from 112 to 225%. The impact was even greater for SMA Type 2 and 3, ranging from 171 to 283% due to high survival rates. However, the budget impact could be mitigated by improved clinical management and PBMEAs, reducing it to 77–84% for Type 1 and 36–117% for Types 2 and 3. Conclusion the introduction of these pioneering interventions for SMA management would raise the overall budget for the payer, primarily due to drug acquisition costs. Nevertheless, this increase could be offset by improvements in clinical management and PBMEAs.https://doi.org/10.1186/s12962-025-00647-3Spinal muscular atrophy (SMA)Budget impact model (BIM)Health technology assessment (HTA)Kingdom of saudi arabia (KSA)Saudi ministry of health (MoH)Performance-based managed entry agreement (PBMEA)
spellingShingle Ahmed Al-jedai
Hajer Al-Mudaiheem
AlJohara AlSakran
Fahad A. Bashiri
Fouad Ghamdi
Mohammad A. Almuhaizea
Abdulaziz AlSamman
Nancy Awad
Rita Ojeil
Pioneering SMA therapies for all types: survival gains, cost dynamics, and performance-based agreements
Cost Effectiveness and Resource Allocation
Spinal muscular atrophy (SMA)
Budget impact model (BIM)
Health technology assessment (HTA)
Kingdom of saudi arabia (KSA)
Saudi ministry of health (MoH)
Performance-based managed entry agreement (PBMEA)
title Pioneering SMA therapies for all types: survival gains, cost dynamics, and performance-based agreements
title_full Pioneering SMA therapies for all types: survival gains, cost dynamics, and performance-based agreements
title_fullStr Pioneering SMA therapies for all types: survival gains, cost dynamics, and performance-based agreements
title_full_unstemmed Pioneering SMA therapies for all types: survival gains, cost dynamics, and performance-based agreements
title_short Pioneering SMA therapies for all types: survival gains, cost dynamics, and performance-based agreements
title_sort pioneering sma therapies for all types survival gains cost dynamics and performance based agreements
topic Spinal muscular atrophy (SMA)
Budget impact model (BIM)
Health technology assessment (HTA)
Kingdom of saudi arabia (KSA)
Saudi ministry of health (MoH)
Performance-based managed entry agreement (PBMEA)
url https://doi.org/10.1186/s12962-025-00647-3
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