PCN46 - Estimating the Budget Impact of Adding Avastin (Bevacizumab) to Front Line Treatment for Advanced Ovarian Cancer in Brazilian Supplementary Health Care System

Abstract

Ovarian cancer (OC) is one of the most lethal gynecologic cancers worldwide. According to Brazilian Institute of Cancer (INCA), 6,190 new OC cases were estimated in 2012. During the last 15 years, carboplatin plus paclitaxel (CP) has been established as front-line (FL) standard of care therapy for advanced ovarian cancer, with no significant advances in treatment ever since. Bevacizumab (Bev) in combination with CP was approved in Brazil for FL treatment of advanced epithelial OC on May/2013. Therefore, this study aimed to estimate the economic impact of bevacizumab reimbursement for advanced OC in Brazilian Supplementary Healthcare System. The potential number of eligible patients for CP + Bev in FL therapy for advanced OC was estimated following an epidemiologic approach. It was assumed that Supplementary Healthcare System attendance accounts for 40% of all patients. Additional drug costs and infusion fees were evaluated. The ex-factory price (VAT 18%) and labeled dose were considered. Average therapy duration of CP + bevacizumab was 15 months based on GOG-0218 trial. Costs were reported in Brazilian Reais (BRL1.00≈USD0.44; Jun/2013). A total health assistance budget of BRL 88.1 billion was forecasted for 2013, based on the last updated data from Brazilian National Regulatory Agency for Private Health Insurance and Plans (ANS). A total of 1,287 eligible cases in CP + Bev FL therapy for advanced OC are expected in 2013 in the private setting. Adding bevacizumab to the treatment of all these potential patients would yield an increase of BRL 267 million, corresponding only to an increment around 0.30% on health assistance expenses. Treating all eligible FL advanced OC patients with CP + Bev will potentially result in a low impact in Supplementary Healthcare System budget, associated to unprecedented clinical benefits for this population with a high medical unmet need.