PCN222 The Cost of STAGE IV Melanoma with BRAF V600 Mutations in Greece

Abstract

At a time when most cancer incidences are falling, the annual incidence of melanoma has risen as rapidly as 4-6% in many European countries, with a substantial economic burden in advanced stages. The purpose of this study is the investigation of treatment pathways and healthcare resource use of advanced BRAF-mutated melanoma in Greece. This study is based on the information collected by an expert panel comprising of 3 oncologists of major public and private melanoma centers around Greece. A 3-round survey was undertaken, according to a modified Delphi method. The treatment phases studied were: pre-progression; disease progression and terminal care. Oncology drug costs, medical visits, laboratory tests, imaging examinations, hospitalizations, radiotherapy/surgery and concomitant medications were the resources considered in the context of the Greek National Services Organization (EOPYY). The most common disease management scenario (80% of cases) in Greece for patients of stage IV BRAF V600 mutated melanoma was: targeted therapies as first line treatment at 95% and 5% for immunotherapies, followed by 95% immunotherapies and 5% targeted therapies as second line and third line treatment at 65% of cases. At third line several therapeutic options were applied, immunotherapies, monotherapy and combination therapies, targeted therapies, chemotherapy and others. The weighted annual cost of treatment was 86.516,88 € for first line treatment at list price and around 41.679,50 based on the negotiated price*. At second line the cost of treatment has been estimated at 21.646,7€ and 58.651,81€ for third line treatment for the most commonly used management scenarios. Μetastatic BRAF mutant melanoma requires prolonged and costly treatment but new therapies managed to substantially increase life expectancy. Identifying the appropriate treatment options in order to optimize health outcomes should be an important priority in healthcare system. *Assumption taking into consideration the baseline standard rebates and discounts of new active substance in Greece.