Your browser doesn't support javascript.
loading
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
Aguiar Júnior, Pedro; Barreto, Carmelia Maria Noia; Roitberg, Felipe; Lopes Júnior, Gilberto; Giglio, Auro del.
  • Aguiar Júnior, Pedro; Faculdade de Medicina do ABC. Department of Oncology. São Paulo. BR
  • Barreto, Carmelia Maria Noia; MD Anderson Cancer Center. Houston. US
  • Roitberg, Felipe; Instituto do Câncer do Estado de São Paulo. São Paulo. BR
  • Lopes Júnior, Gilberto; University of Miami. Sylvester Comprehensive Cancer Center. Miami. US
  • Giglio, Auro del; Faculdade de Medicina do ABC. Centro de Estudos em Hematologia e Oncologia. Santo André. BR
São Paulo med. j ; 137(6): 505-511, Nov.-Dec. 2019. tab, graf
Article in English | LILACS | ID: biblio-1094519
ABSTRACT
ABSTRACT

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.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Health Care Costs / Quality-Adjusted Life Years / Protein Kinase Inhibitors / ErbB Receptors / Lung Neoplasms Type of study: Etiology study / Health economic evaluation Limits: Humans Country/Region as subject: South America / Brazil Language: English Journal: São Paulo med. j Journal subject: Cirurgia Geral / Ciˆncia / Ginecologia / Medicine / Medicina Interna / Obstetr¡cia / Pediatria / Sa£de Mental / Sa£de P£blica Year: 2019 Type: Article Affiliation country: Brazil / United States Institution/Affiliation country: Faculdade de Medicina do ABC/BR / Instituto do Câncer do Estado de São Paulo/BR / MD Anderson Cancer Center/US / University of Miami/US

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Index: LILACS (Americas) Main subject: Health Care Costs / Quality-Adjusted Life Years / Protein Kinase Inhibitors / ErbB Receptors / Lung Neoplasms Type of study: Etiology study / Health economic evaluation Limits: Humans Country/Region as subject: South America / Brazil Language: English Journal: São Paulo med. j Journal subject: Cirurgia Geral / Ciˆncia / Ginecologia / Medicine / Medicina Interna / Obstetr¡cia / Pediatria / Sa£de Mental / Sa£de P£blica Year: 2019 Type: Article Affiliation country: Brazil / United States Institution/Affiliation country: Faculdade de Medicina do ABC/BR / Instituto do Câncer do Estado de São Paulo/BR / MD Anderson Cancer Center/US / University of Miami/US