Pharmacoeconomic analysis of using empegfilgrastim for the treatment of early and locally advanced HER2+ breast cancer in the Russian Federation
M. V. Zhuravleva,
K. A. Kokushkin,
E. A. Luchinin,
E. V. Luchinina,
T. R. Kameneva,
E. V. Kuznetsova,
V. S. Krysanova,
E. V. Makarova,
L. G. Zhukova https://doi.org/10.17749/2070-4909/farmakoekonomika.2023.220
Abstract
Objective: to assess budget impact of using empegfilgrastim for the prevention of febrile neutropenia in patients with early and locally advanced human epidermal growth factor receptor 2 positive (HER2+) breast cancer who receive neoadjuvant “docetaxel / carboplatin / trastuzumab + pertuzumab” regimen, considering possible subsequent adjuvant therapy with trastuzumab emtansine or trastuzumab within the Russian healthcare system.
Material and methods. We searched and analyzed published clinical, epidemiological and pharmacoeconomic studies as well as regulatory and legal documents. A decision tree model was constructed to reflect the probabilities of switching to different adjuvant therapy regimens depending on the achievement of pathomorphological complete response in patients with early and locally advanced HER2+ breast cancer. The budget impact analysis was carried out comparing two primary prophylactic options, empegfilgrastim and filgrastim.
Results. Despite the higher costs of prevention with empegfilgrastim compared to filgrastim (249 vs. 134 thousand rubles), due to the higher rate of achieving a pathomorphological complete response and, accordingly, fewer cases requiring adjuvant therapy with the more expensive trastuzumab emtanzine, savings of 916 thousand rubles per 1 patient per 1 year of therapy are possible. In general, prophylaxis in the target population diagnosed with early and locally advanced HER2+ breast cancer using empegfilgrastim will result in a cost reduction of 9.4 billion rubles per 1 year compared to filgrastim.
Conclusion. Empegfilgrastim prophylaxis, despite its higher annual cost, is an efficient option within the Russian healthcare system. In addition to reducing the incidence of febrile neutropenia, the frequency and dose of chemotherapy are preserved, resulting in increased efficacy of the primary therapy.
Supporting agencies: The article was prepared with the support of Biocad JSC (Russia). The sponsor participated in the development of the research project and the support of the research program, as well as the decision to submit the article for publication, which did not affect the results of the study. The authors are fully responsible for the final version of the manuscript.
About the Authors
M. V. Zhuravleva
Sechenov University;
Scientific Center for Expert Evaluation of Medicinal Products
Russian Federation
Russian Federation
Dr. Med. Sci., Professor, Chair of Clinical Pharmacology and Propaedeutics of Internal Diseases; Deputy Head of
Scientific Department of Clinical Pharmacology, Institute of Research and Development
Scopus Author ID: 5587891790
8 bldg 2 Trubetskaya Str., Moscow 119048, Russia
8 bldg 2 Petrovsky Bvrd, Moscow 127051, Russia
K. A. Kokushkin
Scientific and Practical Center for Clinical and Economic Analysis of the Ministry of Health of the Moscow Region
Russian Federation
Russian Federation
Scientific Adviser
4 lit. А Karbyshev Str., Krasnogorsk 143403, Russia
E. A. Luchinin
Razumovsky Saratov State Medical University
Russian Federation
Russian Federation
Member of Chair of Pathology, Hematology and Clinical Pharmacology
Scopus Author ID: 57220079650
112 Bolshaya Kazachya Str., Saratov 410012, Russia
E. V. Luchinina
Razumovsky Saratov State Medical University
Russian Federation
Russian Federation
MD, PhD, Associate Professor, Chair of Pathology, Hematology and Clinical Pharmacology, Head of Department of Control over the Circulation of Medicines and Medical Devices, Clinical Center
WoS ResearcherID: AAD-4774-2021; Scopus Author ID: 57217133083
112 Bolshaya Kazachya Str., Saratov 410012, Russia
T. R. Kameneva
Research Institute of Healthcare Organization and Medical Management;
Konchalovsky City Clinical Hospital
Russian Federation
Russian Federation
MD, PhD, Associate Professor, Leading Expert, Organizational and Methodological Department of Clinical Pharmacology; Clinical Pharmacologist
9 Sharikopodshipnikovskaya Str., Moscow 115088, Russia
2 bldg 1 Kashtanovaya Alley, Moscow, Zelenograd 124489, Russia
E. V. Kuznetsova
Research Institute of Healthcare Organization and Medical Management
Russian Federation
Russian Federation
Head of Organizational and Methodological Department of Clinical Pharmacology
9 Sharikopodshipnikovskaya Str., Moscow 115088, Russia
V. S. Krysanova
Russian Biotechnological University
Russian Federation
Russian Federation
Member of Chair of Therapy with a Course of Pharmacology and Pharmacy, Medical Institute of Continuing Education
WoS ResearcherID: AAE-2346-2019; Scopus Author ID:
57193874403
11 Volokolamskoe Shosse, Moscow 125080, Russia
E. V. Makarova
Yevdokimov Moscow State University of Medicine and Dentistry
Russian Federation
Russian Federation
MD, PhD, Researcher
Scopus Author ID: 57201075018
20 bldg 1 Delegatskaya Str., Moscow 127473, Russia
L. G. Zhukova
Loginov Moscow Clinical Research and Practical Center
Russian Federation
Russian Federation
Dr. Med. Sc., Corresponding Member of RAS, Deputy Director for Oncology
1 corp. 1 Novogireevskaya Str., Moscow 111123, Russia
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For citations:
Zhuravleva M.V., Kokushkin K.A., Luchinin E.A., Luchinina E.V., Kameneva T.R., Kuznetsova E.V., Krysanova V.S., Makarova E.V., Zhukova L.G. Pharmacoeconomic analysis of using empegfilgrastim for the treatment of early and locally advanced HER2+ breast cancer in the Russian Federation. FARMAKOEKONOMIKA. Modern Pharmacoeconomics and Pharmacoepidemiology. 2023;16(4):537-549. (In Russ.) https://doi.org/10.17749/2070-4909/farmakoekonomika.2023.220
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