Background Belimumab is a monoclonal antibody indicated as add-on treatment in adult patients with active systemic lupus erythematosus (SLE) despite standard treatment. Given its modest efficacy and the lack of data for severe forms, the improvement in actual benefit (IAB) of belimumab was assessed to be minor. Thus, Health Authorities approved the hospital use of belimumab but its administration in hospital settings is not supported by health insurance.

Purpose To assess the cost impact of belimumab treatment in adult patients with SLE in our hospital.

Material and methods Data available from the SLE population in the Internal Medicine Department was used as input in the model. An Excel model was adopted for the analysis, which was performed from our hospital perspective. The recommended dose regimen was 10 mg/kg on days 0, 14 and 28 and at 4-week intervals thereafter. Patients received their treatment as part of a day hospital admission. Total charges and costs details were obtained from the National Tariffs Databases.

Results A retrospective analysis was conducted on a dataset of 12 female patients followed over a period of 15 months (from January 2013 to May 2014).

Based on a cost of €162.65 for a 120 mg vial and €542.15 for a 400 mg vial, the cost of belimumab per course and per patient was estimated at €972.5 whereas only €30 (drug-related reimbursement in the total hospital daily costs) were refunded to the hospital. 113 courses of treatment were recorded during this period. Therefore, a total of €106,504 remained chargeable to the hospital.

Conclusion Despite some evidence of its clinical effectiveness, the health benefits could be outweighed by the significant costs associated with belimumab. It is important to target patients most likely to benefit from belimumab, to establish well-defined optimal treatment duration, or even to consider other therapeutic alternatives.

References and/or Acknowledgements Thanks to N. MEBARKI JVR Bondy.

No conflict of interest.