Resmetirom for noncirrhotic metabolic dysfunction-associated steatohepatitis with liver fibrosis: establishing a value-based price in China, the UK, France, and Germany.

BACKGROUND: Resmetirom is the first approved pharmacological treatment for adults with noncirrhotic metabolic dysfunction-associated steatohepatitis (MASH) and moderate-to-advanced fibrosis (F2-F3). We estimated its value-based annual price in China, the United Kingdom, France, and Germany from the health-care payer perspective. RESEARCH DESIGN AND METHODS: We developed an annual-cycle Markov model for eligible F2-F3 patients receiving standard of care (SoC) or resmetirom plus SoC. Country-specific epidemiology, costs, and willingness-to-pay (WTP) thresholds were applied. Value-based pricing (VBP) was the annual price at which the incremental cost-effectiveness ratio (ICER) equaled the country-specific WTP threshold per quality-adjusted life-year (QALY). Analyses included ICERs at the current US price and probabilistic sensitivity analysis. RESULTS: Resmetirom increased life-years (LYs) by 0.30, 0.71, 0.96, and 0.80 in China, the UK, France, and Germany, with QALY gains of 0.47, 0.96, 1.28, and 1.07. Estimated VBPs were US$3,573, US$6,487, US$9,334, and US$10,656, respectively. At the current US annual price, ICERs exceeded country-specific WTP thresholds in all settings. CONCLUSIONS: Price reductions toward country-specific VBPs would be required for resmetirom to be cost-effective in these publicly financed health systems.