Real-World Prevalence and Outcomes of Patients with Paroxysmal Nocturnal Hemoglobinuria Treated with C5 Inhibitors in the US: A Retrospective Claims Database Analysis

# Background Paroxysmal nocturnal hemoglobinuria (PNH) is a rare blood disorder with C5 inhibitors (C5i), eculizumab and ravulizumab, being part of current treatment options. # Objectives To estimate the 5-year prevalence of PNH and describe the healthcare resource utilization and direct healthcare...

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Main Authors: Srinivas K Tantravahi, Dominick Latremouille-Viau, Raj Desai, Soyon Lee, Jincy Paulose, Anumaxine Geevarghese, Annie Guérin, Shravanthi Seshasayee, Mohin Chanpura, Glorian Yen
Format: Article
Language:English
Published: Columbia Data Analytics, LLC 2025-08-01
Series:Journal of Health Economics and Outcomes Research
Online Access:https://doi.org/10.36469/001c.142049
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Summary:# Background Paroxysmal nocturnal hemoglobinuria (PNH) is a rare blood disorder with C5 inhibitors (C5i), eculizumab and ravulizumab, being part of current treatment options. # Objectives To estimate the 5-year prevalence of PNH and describe the healthcare resource utilization and direct healthcare costs associated with C5i among commercially insured patients with PNH treated with C5i in the US. # Methods The 5-year prevalence of adults with PNH in IQVIA PharMetrics® Plus was estimated (2018-2022). A retrospective cohort study (2011-2022) was also conducted in adults with PNH treated with C5i and ≥3 months of continuous health plan coverage following the first claim for C5i (index date). PNH-related health resource utilization and direct healthcare costs were assessed from index date until earliest of treatment discontinuation/end of data/end of continuous health plan coverage (follow-up period). # Results The 5-year prevalence of PNH was 2.4 per 100 000 persons in commercial claims. A total of 371 patients treated with C5i (median age: 40 years; female: 55.3%; eculizumab: 53.9%; ravulizumab: 46.1%) were followed for a mean ± SD [median] of 19.3 ± 16.9 [14.7] months. Annual incidence rates of PNH-related blood transfusion and breakthrough hemolysis (BTH) among patients treated with C5i were 1.2 (eculizumab: 1.3; ravulizumab: 1.0) and 4.5 (eculizumab: 5.2; ravulizumab: 3.3) per person per year (PPPY), respectively. In patients treated with eculizumab and ravulizumab, respectively, PNH-related blood transfusion was required by 46.2% and 11.9% of patients in the first 6 months post-index, and over the follow-up period, transfusion avoidance was observed in 46.2% and 78.2% of patients. The 6- and 12-month rates of PNH-related thrombosis were 8.0% and 10.6% for eculizumab and 6.1% and 11.6% for ravulizumab, respectively. Among patients treated with C5i, estimated annual total PNH-related costs PPPY were $660 533 (eculizumab: $697 459; ravulizumab: $612 522) for the first year and $633 984 (eculizumab: $691 022; ravulizumab: $570 832) for subsequent years, with treatment costs accounting for 94.3% to 94.6% of total costs. # Discussion Despite treatment with C5i, patients with PNH still exhibited BTH, required blood transfusions, and experienced thrombosis. # Conclusion This study highlights the unmet need for more effective PNH treatments to address the economic and clinical burden associated with PNH and improve disease control among patients.
ISSN:2327-2236