Abstract
Modern therapeutic approaches in treatment of advanced breast cancer can achieve clinically significant regression of symptoms, prolong life and improve its quality. Aim of this study was to conduct clinical and economic analysis of application of everolimus in the treatment of hormone-receptor-positive (HR+), human epidermal growth factor receptor-2-negative (HER2-) advanced breast cancer in postmenopausal women. An epidemiological and pharmacoeconomic evaluation of HR+, HER2- advanced breast cancer in postmenopausal women with using a survey of experts from different regions of Russia and modeling method. Calculating the cost of drugs and medical services was conducted according to experts and standard of medical care. Filling of a Markov model was conducted without using and with using of everolimus in the treatment of the patients within 5 years. Calculated indicators were: the impact of the disease on budget, the cost of one additional year of life. From 13 regions of Russia 8 experts refused to provide information on the questionnaire, which may indicate the unwillingness to disclose information on epidemiology and tactics of treatment of disease. The burden of breast cancer for 5 years without the use of everolimus in the treatment regimens of patients with postmenopausal HR+, HER2- advanced breast cancer and with using it were: in Moscow 118.668.419€ and 137.596.651€; St. Petersburg-36.730.318€ and 38.133.492€; Republic of Khakassia-18.854.270€ and 19.812.467€; Omsk region-32.428.540€ and 33.603.456€; Primorsky Krai-39.176.077€ and 40.877.880€. The use of of everolimus with exemestane in the treatment of advanced breast cancer increases by 1.5-2 times life expectancy and its "cost-effectiveness" indicator is 2 times lower comparing to exemestane monotherapy and chemotherapy. Sensitivity analysis using the results from 5 regions of Russia showed unidirectional comparison. The use of everolimus with exemestane is the dominant technology of treatment HR+, HER2- advanced breast cancer in postmenopausal patients compared with traditional technology of application of chemotherapy drugs or exemestane alone.
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