Prevalence of Use and Cost of Biological Drugs for Cancer Treatment: A 5-Year Picture from Southern Italy

Abstract

Background and ObjectivesConsidering the clinical and economic burden of biological and non-biological targeted therapies in cancer treatment, it is necessary to explore how these drugs are used in routine care in Italy and how they affect the sustainability of the National Health Services. This study aimed to investigate the prevalence of use and costs of biological and non-biological targeted therapies for cancer treatment in a general population of Southern Italy in the years 2010–2014.MethodsThis was a retrospective, observational study using data from the healthcare administrative databases of Messina Province for the years 2010–2014. In this study, users of biological and non-biological targeted therapies for cancer treatment were characterized and the prevalence of use and costs were calculated over time. The potential impact of biosimilars on the expenditure was also estimated.ResultsOf a population of 653,810 residents in the Messina area during the study years, 2491 (0.4%) patients received at least one study drug. The most frequently used were monoclonal antibodies (mAbs) (n = 1607; 64.5%) and tyrosine kinase inhibitors (TKIs) (n = 609; 24.4%). mAbs were mainly used by females (60.3%) for metastasis due to an unspecified primary tumor, lymphomas, or breast cancer (24.2, 16.7, and 13.7%, respectively). Most users of small molecules were males (56.3%) being treated for multiple myeloma, metastasis due to unspecified primary tumor, leukemia, and lung cancer (13.1, 12.6, 9.5, and 8.9%, respectively). During the study years, the prevalence of use doubled from 0.9 to 1.8 per 1000 inhabitants; likewise, the related expenditure grew from €6.6 to €13.6 million. Based on our forecasts, this expenditure will grow to €25 million in 2020. Assuming a 50% biosimilar uptake (trastuzumab and rituximab), a potential yearly saving of almost €1 million may be achieved.ConclusionsIn recent years, the use and costs of biological and non-biological targeted therapies in cancer patients dramatically increased in a large population from Southern Italy. This trend may be counterbalanced by adopting biosimilars once they are available. Claims databases represent a valid tool to monitor the uptake of newly marketed biological drugs and biosimilars as well as other non-biological targeted therapies.Electronic supplementary materialThe online version of this article (doi:10.1007/s40261-017-0591-3) contains supplementary material, which is available to authorized users.

Cost‐effectiveness analysis of the new oncological drug durvalumab in Italian patients with stage III non‐small cell lung cancer

“…As reported by other studies, 34,35 the costs of cancer care have risen dramatically in the past decade. Specifically, the prevalence of patients undergoing new oncological therapies and associated spending have more than doubled.…”

“…15 Finally, a recent study by Giuliani et al demonstrated that durvalumab could be considered cost-effective, with an ICER of €3717 per month of PFS gained. 16,33 As reported by other studies, 34,35 the costs of cancer care have risen dramatically in the past decade. Specifically, the prevalence of patients undergoing new oncological therapies and associated spending have more than doubled.…”