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
São Paulo med. j
; São Paulo med. j;137(6): 505-511, Nov.-Dec. 2019. tab, graf
Article
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| LILACS
| ID: biblio-1094519
Biblioteca responsable:
BR1.1
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 ANDSETTING:
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.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
LILACS
Asunto principal:
Costos de la Atención en Salud
/
Años de Vida Ajustados por Calidad de Vida
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Inhibidores de Proteínas Quinasas
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Receptores ErbB
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Neoplasias Pulmonares
Tipo de estudio:
Etiology_studies
/
Health_economic_evaluation
Aspecto:
Patient_preference
Límite:
Humans
País/Región como asunto:
America do sul
/
Brasil
Idioma:
En
Revista:
São Paulo med. j
Asunto de la revista:
Cirurgia Geral
/
Cincia
/
Ginecologia
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MEDICINA
/
Medicina Interna
/
Obstetr¡cia
/
Pediatria
/
Sa£de Mental
/
Sa£de P£blica
Año:
2019
Tipo del documento:
Article
País de afiliación:
Brasil
/
Estados Unidos
Pais de publicación:
Brasil