Potential life years not saved due to lack of access to anti-EGFR tyrosine kinase inhibitors for lung cancer treatment in the Brazilian public healthcare system: Budget impact and strategies to improve access. A pharmacoeconomic study
| Autor: | Pedro Aguiar Júnior, Carmelia Maria Noia Barreto, Felipe Roitberg, Gilberto Lopes Júnior, Auro del Giglio |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Budgets
medicine.medical_specialty Lung Neoplasms Cost-Benefit Analysis Afatinib medicine.medical_treatment Access to therapy Health Services Accessibility Targeted therapy 03 medical and health sciences 0302 clinical medicine Gefitinib Non-small cell lung cancer medicine Humans Molecular targeted therapy Molecular Targeted Therapy 030212 general & internal medicine Lung cancer Intensive care medicine Protein Kinase Inhibitors health care economics and organizations Budget impact assessment business.industry Cancer Health Care Costs General Medicine medicine.disease Survival Analysis Health policy Risk Sharing Financial Quality-adjusted life year ErbB Receptors Erlotinib Pharmacoeconomic Study Quinazolines Medicine Quality-Adjusted Life Years business Economics pharmaceutical Brazil 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | Sao Paulo Medical Journal v.137 n.6 2019 São Paulo medical journal Associação Paulista de Medicina instacron:APM São Paulo Medical Journal, Vol 137, Iss 6, Pp 505-511 (2020) |
| Popis: | BACKGROUND: Lung cancer is the fourth most common cancer in Brazil. In the 2000s, better understanding of molecular pathways led to development of epidermal growth factor receptor (EGFR)-targeted treatments that have improved outcomes. However, these treatments are unavailable in most Brazilian public healthcare services (Sistema Único de Saúde, SUS). OBJECTIVE: To assess the potential number of years of life not saved, the budget impact of the treatment and strategies to improve access. DESIGN AND SETTING: Pharmacoeconomic study assessing the potential societal and economic impact of adopting EGFR-targeted therapy within SUS. METHODS: We estimated the number of cases eligible for treatment, using epidemiological data from the National Cancer Institute. We used data from a single meta-analysis and from the Lung Cancer Mutation Consortium (LCMC) study as the basis for assessing differences in patients’ survival between use of targeted therapy and use of chemotherapy. The costs of targeted treatment were based on the national reference and were compared with the amount reimbursed for chemotherapy through SUS. RESULTS: There was no life-year gain with EGFR-targeted therapy in the single meta-analysis (hazard ratio, HR, 1.01). The LCMC showed that 1,556 potential life-years were not saved annually. We estimated that the annual budget impact was 125 million Brazilian reais (BRL) with erlotinib, 48 million BRL with gefitinib and 52 million BRL with afatinib. Their incremental costs over chemotherapy per life-year saved were 80,329 BRL, 31,011 BRL and 33,225 BRL, respectively. A drug acquisition discount may decrease the budget impact by 30% (with a 20% discount). A fixed cost of 1,000 BRL may decrease the budget impact by 95%. CONCLUSION: Reducing drug acquisition costs may improve access to EGFR-targeted therapy for lung cancer. |
| Databáze: | OpenAIRE |
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