Cost-minimisation analysis of erlotinib in the second-line treatment of non-small-cell lung cancer: a Brazilian perspective

A cost-minimisation and budget impact analysis of erlotinib versus docetaxel or pemetrexed as second-line treatment for advanced non-small-cell lung cancer (NSCLC). Costs and budgetary impacts were estimated from the perspective of a Brazilian private healthcare payer, based on results of the BR.21...

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Bibliographic Details
Published in:	Journal of medical economics Vol. 11; no. 3; p. 383
Main Authors:	Doral Stefani, Stephen, Giorgio Saggia, Mario, Vicino dos Santos, Eduardo Augustus
Format:	Journal Article
Language:	English
Published:	England 2008
Subjects:	Antineoplastic Agents - economics Antineoplastic Agents - therapeutic use Brazil Carcinoma, Non-Small-Cell Lung - drug therapy Clinical Trials, Phase III as Topic Cost Control Disease-Free Survival Erlotinib Hydrochloride Glutamates - economics Glutamates - therapeutic use Guanine - analogs & derivatives Guanine - economics Guanine - therapeutic use Humans Lung Neoplasms - drug therapy Pemetrexed Quinazolines - economics Quinazolines - therapeutic use Sensitivity and Specificity Taxoids - economics Taxoids - therapeutic use Brazil
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Summary:	A cost-minimisation and budget impact analysis of erlotinib versus docetaxel or pemetrexed as second-line treatment for advanced non-small-cell lung cancer (NSCLC). Costs and budgetary impacts were estimated from the perspective of a Brazilian private healthcare payer, based on results of the BR.21 study of erlotinib and pivotal trials of docetaxel and pemetrexed. A 126-day timeframe was evaluated, based on the progression-free survival determined for erlotinib in BR.21. A Delphi panel identified local practices and associated costs in Brazil. Other costs accounted for included medical payments, pre- and post-chemotherapy medication and drug administration costs. Multivariate sensitivity analyses were performed, but given the short time frame used, discounting was not applied. Total costs were R$26,825 for erlotinib, R$42,284 for docetaxel and R$79,841 for pemetrexed. Cost savings with erlotinib were attributable to lower acquisition costs (R$26,795 vs. R$40,217 for docetaxel and R$78,911 for pemetrexed) and lower costs for the management of side effects. Sensitivity analyses confirmed the robustness of the results. The budget impact analysis showed savings with erlotinib in the first year, ranging from R$3 million to R$28 million. Erlotinib is cost-saving over established chemotherapy in the second-line treatment of advanced NSCLC under the Brazilian private healthcare system.
ISSN:	1369-6998
DOI:	10.3111/13696990802208186