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
; 137(6): 505-511, Nov.-Dec. 2019. tab, graf
Artigo
em Inglês
| LILACS
| ID: biblio-1094519
Biblioteca responsável:
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.
Texto completo:
Disponível
Temas:
ECOS
/
Aspectos gerais
/
Financiamento e gastos
Bases de dados:
LILACS
Assunto principal:
Custos de Cuidados de Saúde
/
Anos de Vida Ajustados por Qualidade de Vida
/
Inibidores de Proteínas Quinases
/
Receptores ErbB
/
Neoplasias Pulmonares
Tipo de estudo:
Estudo de etiologia
/
Avaliação econômica em saúde
Aspecto:
Preferência do paciente
Limite:
Humanos
País/Região como assunto:
América do Sul
/
Brasil
Idioma:
Inglês
Revista:
São Paulo med. j
Assunto da revista:
Cirurgia Geral
/
Cincia
/
Ginecologia
/
Medicina
/
Medicina Interna
/
Obstetr¡cia
/
Pediatria
/
Sa£de Mental
/
Sa£de P£blica
Ano de publicação:
2019
Tipo de documento:
Artigo
País de afiliação:
Brasil
/
Estados Unidos
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