Budget Impact Analysis of Aflibercept in yhe Treatment of Metastatic Colorectal Cancer (MCRC) in Poland

Abstract

Objectives: To allow budgeting of pharmaceutical expenditure for cancer drugs in Germany, we forecasted future outpatient pharmaceutical expenditure for cancer treatment from the perspective of the statutory health insurance (SHI) for 2016. MethOds: Based on data of the Techniker Krankenkasse (TK), a large German sickness fund with more than 8.2 million insured, we forecasted pharmaceutical expenditure for 12 cancer indications in 2016 (according to ICD-10: C16, C18-21, C22, C26.9/C49.9, C34, C43, C50, C56, C61, C73, C90, C91.1). To extrapolate results to whole SHI, we adjusted for differences in demographics of insured between TK and SHI using publicly available data, i.e. KM6 statistics. We also incorporated trends in membership to SHI. To assess the impact of new drugs, we obtained expert opinion by IMS Health on (a) the timing of drug launches in the German cancer market, (b) the expected prices of new drugs and (c) the extent to that new drugs will replace existing pharmaceuticals. For calculations, we assumed that newly launched drugs will reach on average a diffusion of 20% of their market potential until 2016. Results: According to our model, SHI outpatient pharmaceutical expenditure for these 12 cancer indications was million € 2,780 in 2012, i.e., 9.5% of total outpatient pharmaceutical expenditure. In 2016, we expect annual pharmaceutical expenditure for these indications to increase by 17.2% to million € 3,258. Of the 26 new drugs identified to be launched until 2016,10 will at least partly replace existing pharmaceutical treatments. Thus, million € 526 of our budget estimate will be due to new drugs, € 2,650 million will be due to pharmaceuticals that were already launched in 2012 while € 82 million will be due to demographic change. cOnclusiOns: The expected increase in costs for cancer drugs are a financial challenge for German SHI. Whether benefit of new drugs and expected costs can be considered fair value needs to be investigated elsewhere.Objectives: To determine the budget impact of everolimus (in combination with letrozole/anastrozole) as a second-line treatment for ER+ HER2-negative advanced and metastatic breast cancer in postmenopausal women in Kazakhstan. MethOds: A cumulative cohort model was developed to estimate the five-year costs associated with introducing everolimus to the Kazakh health care system, with two scenarios: "with everolimus" and "without everolimus". Treatment-specific PFS and OS data were extrapolated from trial data using a Weibull function. It was assumed that data from the BOLERO-2 trial (everolimus+exemestane vs exemestane alone) were representative of everolimus+letrozole/anastrozole and letrozole/anastrozole used in the model. Per-patient drug, health state, adverse event costs were calculated. The per-patient costs were multiplied by the number of patients expected to receive each treatment according to predicted market share, which was split between everolimus+letrozole/anastrozole, letrozole/anastrozole alone, chemotherapy and tamoxifen. Results: The within-tr...

Aflibercept: A Review in Metastatic Colorectal Cancer

“…Additional health-related QoL data from the ongoing ASQoP study may provide real-life data for further robust pharmacoeconomic analyses. Preliminary results (abstract presentations) from budget impact [43,44] and cost-effectiveness [45] analyses in patients with mCRC suggest that aflibercept may be cost saving from healthcare payer's perspective in the USA [43] and Poland [44], and potentially more cost-effective than bevacizumab [45].…”