Drug Cost Per Gained Month in Overall Survival (Os) and Progression-Free Survival (Pfs) of Selected Solid Tumour Therapies in Nordic Countries

Abstract

ABSTRACT Aim: Regional and hospital payers increasingly require analyses assessing the cost-benefit profile of new drugs. This analysis evaluates the cost profile in Nordic countries of nano albumin-bound paclitaxel (nab-paclitaxel [nab-P]) in pancreatic cancer vs other drugs per gained month in OS and PFS in high-unmet need solid tumour indications. Methods: Trial data on solid tumour therapies (comparator, treatment duration, PFS, OS) was retrieved from the European Medicine Agency (EMA) website. Total drug costs were calculated from ex-manufacturer prices without local discounts, using minimization of wastage and costs, and multiplying each drug cost by its maximum number of cycles or until disease progression, according to posology indications. Costs per month of OS and PFS achieved (dividing total drug costs by OS and PFS months, respectively) were evaluated for a selection of drugs: (1) trials for first-line metastatic cancer or noncurable treatment intention patients; (2) approved by EMA after 2000; (3) indicated in high-unmet need tumours (defined as OS for trial comparator ≤ 12 mo). Results: Results for the OS analysis are shown on the table: In all countries, a good correlation between costs per OS month and relative benefit vs trial comparator was observed. Similar correlation was found for the PFS analysis. Conclusions: The most recently approved drug, nab-P in pancreatic cancer, showed a similar cost per OS or PFS month ratio compared with other drugs for high-unmet need solid tumours. Drug Indication (year of EMA approval) Relative OS Gain vs Trial Comparator Total Drug Cost per OS Month (e) Norway Denmark Finland Sweden nab-P Pancreas (2014) 27% 1407 1697 2003 2280 Pemetrexed Mesothelioma (2004) 30% 1875 1886 1991 2064 Bevacizumab Lung (2007) 19% 1810 1531 1620 1722 Cetuximab Head and neck (2004) 36% 3036 2865 2828 2972 Trastuzumab Stomach (2009) 24% 1743 1008 1786 1945 Erlotinib Pancreas (2006) 7% 1119 870 1209 950 Tegafur/gimeracil/ oteracil (Teysuno S-1) Stomach (2011) 9% 264 236 185 249 Temsirolimus Kidney (2007) 49% 1736 1315 1411 1539 Vemurafenib Melanoma (2012) 40% 5864 4700 4814 4,919 Ipilimumab Melanoma (2011) 67% 8741 6725 6964 7248 Disclosure: P. Osterlund: No financial disclosures, panelist on the Metastatic pancreatic cancer webcast for Celgene in April 2014; P. Pfeiffer: No financial disclosures, chairman on the Metastatic pancreatic cancer webcast for Celgene in April 2014; R. Smaaland: Rune Smaaland has no financial disclosures. He has been in the scientific panel on the Metastatic pancreatic cancer webcast for Celgene in April 2014; F. Rodrigues: Employment or leadership position and stock ownership, Celgene; G. Furneri: No financial disclosures, panelist on the Metastatic pancreatic cancer webcast for Celgene in April 2014; Consulting fees from Celgene.