Preview

FARMAKOEKONOMIKA. Modern Pharmacoeconomics and Pharmacoepidemiology

Advanced search

Pharmacoeconomic efficacy of atesolizumab compared with other PD-1 inhibitors in patients with advanced non-small cell lung cancer after chemotherapy

https://doi.org/10.17749/2070-4909.2020.13.1.5-12

Abstract

Aim: to evaluate the pharmacoeconomic efficacy of the application of the atesolizumab (PD-L1 inhibitor) preparation compared with other control point inhibitors (PD-1 inhibitors) in patients with advanced non-small cell lung cancer (NSCLC) after chemothe rapy.

Materials and methods. Study design included a retrospective analysis of literature data and modeling. Based on the calculations conducted in a Microsoft Excel model, we analyzed the effect of minimizing costs on using comparable drugs with comparable efficacy; we evaluated how the provision of all patients with NSCLC will impact the health system budget taking into consideration the fact that all these patients are currently provided with PD-1 inhibitors in the second and third lines and with the atezolizumab preparation. For calculations, we used the prices stated in the state register of maximum selling prices; the weighted average maximum wholesale premium was calculated according to the Federal Antimonopoly Service (FAS).

Results. In the analysis of cost minimization, atesolizumab proved itself to be highly clinically and economically effective. It allowed reducing the costs by 28.6% over 3 years compared with the use of nivolumab, and by 31.3% compared with the use of pembrolizumab in the second- and third-line NSCLC treatment regimen. Analysis of the impact on the budget showed that if all 848 patients currently receiving PD-1/PD-L1 inhibitors in the second- and third-line NSCLC treatment regimens had been initially provided with atesolizumab, this would have reduced the pressure on budget by 21.90% or 664.25 million rubles for 3 years.

Conclusion. The use of the atesolizumab preparation is pharmacoeconomically reasonable and appropriate in comparison with the use of nivolumab and pembrolizumab. It will allow reducing the cost of PD-1/PD-L1 inhibitors in the second- and third-line NSCLC treatment regimens. 

About the Authors

S. K. Zyryanov
Peoples’ Friendship University Of Russia
Russian Federation

Sergey K. Zyryanov – MD, Dr Sci Med, Professor & Head, Department of General and Clinical Pharmacology; Deputy Chief Medical Officer, Clinical Hospital No. 24, Department of Healthcare of the City of Moscow

 Researcher ID: D-8826-2012. RISIN SPIN-code: 2725-9981

10/3 Miklukho-Maklaya Str., Moscow 117198



I. N. Diyakov
Research Institute of Vaccines and Serums named after I.I. Mechnikov ; Scientific and Practical Center for the Study of the Problems of Rational Pharmacotherapy and Pharmacoeconomics
Russian Federation

Ilya N. Diyakov – PhD (Biology), Head of the Laboratory of Biosynthesis of Immunoglobulinesa; General Manager

 RISIN SPIN-code: 1854-0958

5А Malyy Kazennyy pereulok, Moscow 105064; 50, bld. 2 Aviamotornaya Str., Moscow 111024



References

1. The status of cancer care for the population of Russia in 2018. Ed. A.D. Kaprin, V.V. Starinsky, G.V. Petrova. Moscow. 2019; (in Russ).

2. Clinical recommendations. Lung cancer. Ministry of Health care. Association of Oncologists of Russia. Russian Society of Clinical Oncology. Moscow. 2018; (in Russ).

3. Instructions for use of the medicinal product for medical use Oddivo. State Register of Medicinal Products [Electronic resource] URL: http://grls.rosminzdrav.ru/Grls_View_v2.aspx?routingGuid=f6ac1a6a9f33-4eaa-a603-b2928d720378&t=]. Accessed: 23.09.2019 (in Russ).

4. Instructions for use of the drug for medical use of Kitrud. State Register of Medicinal Products [Electronic resource] URL: http://grls. rosminzdrav.ru/Grls_View_v2.aspx?routingGuid=88450c76-24e543ee-bbd3-afd10dc1e7c8&t=. Accessed: 23.09.2019 (in Russ).

5. Instructions for the medical use of the drug Tecentric. State Register of Medicinal Products [Electronic resource] URL: https://grls.rosminzdrav. ru/Grls_View_v2.aspx?routingGuid=c210e8ba-5f80-4dc6-90bc98e51fb468ed&t=]. Accessed: 23.09.2019 (in Russ).

6. Crе`quit P., Chaimani A., Yavchitz A., Attiche N., Cadranel J., Trinquart L., Ravaud P. Comparative efficacy and safety of second-line treatments for advanced non-small cell lung cancer with wild-type or unknown status for epidermal growth factor receptor: a systematic review and network meta-analysis. BMC Med. 2017 Oct 30; 15 (1): 193. DOI: https://doi.org/10.1186/s12916-017-0954-x.

7. Rittmeyer A., Barlesi F., Waterkamp D. et al. OAK Study Group. Atezolizumab versus docetaxel in patients with previously treated nonsmall-cell lung cancer (OAK): a phase 3, open-label, multicentre randomised controlled trial. Lancet. 2017; 389 (10066): 255-265. DOI: https://doi.org/10.1016/S0140-6736(16)32517-X.

8. Tariff agreement for the payment of medical care provided under the territorial program of compulsory medical insurance of the city of Moscow for 2019 (in Russ).

9. Decree of the Government of the Russian Federation of 08.28.2014 N 871 (as amended on 11/20/2018) “On approval of the Rules for the formation of lists of drugs for medical use and the minimum range of drugs required for the provision of medical care” (in Russ).

10. Decree of the Government of the Russian Federation of October 29, 2018 No. 1283 “On Amending the Rules for the Formation of the Lists of Medicinal Products for Medical Use and the Minimum Assortment of Medicinal Products Needed to Provide Medical Care” (in Russ).

11. Guidelines for conducting clinical and economic analysis. Moscow. 2016 (in Russ).

12. Guidelines for assessing the impact on the budget in the framework of the program of state guarantees of free medical care for citizens. Moscow. 2016; 27 s. (in Russ).


Review

For citations:


Zyryanov S.K., Diyakov I.N. Pharmacoeconomic efficacy of atesolizumab compared with other PD-1 inhibitors in patients with advanced non-small cell lung cancer after chemotherapy. FARMAKOEKONOMIKA. Modern Pharmacoeconomics and Pharmacoepidemiology. 2020;13(1):5-12. (In Russ.) https://doi.org/10.17749/2070-4909.2020.13.1.5-12

Views: 1451


ISSN 2070-4909 (Print)
ISSN 2070-4933 (Online)