PCN69 - Budget Impact Analysis of First-Line Treatment with Branded Pemetrexed (ALIMTA) for Advanced Non-Squamous Non-Small Cell Lung Cancer in China

Abstract

Non-small cell lung cancer (NSCLC) is a challenge for healthcare providers in China due to rising incidence and associated budgetary pressures. To our knowledge, there is no published budget-impact guiding the choice of first-line chemotherapy for advanced non-squamous NSCLC in China. Therefore, we developed an interactive model to aid decision-making for the introduction of branded pemetrexed (Alimta) for first-line advanced non-squamous NSCLC, from payers’ perspective. The objective of this study was to evaluate the difference in total treatment costs between the new and old chemotherapies for NSCLC, including branded pemetrexed (Alimta) and generic pemetrexed in China. The budget impact model was constructed from a payers’ perspective. The model parameters were obtained from literature. We assumed that patients in pemetrexed cohort, excluding third-generation chemotherapies, received all available first-line therapy until disease progression. Pharmacological costs and the costs associated with adverse events were considered. The cost of treatments was calculated on a per-patient basis. Based on input of patient numbers into the model, the total costs of both current and alternate treatments were calculated. All costs were expressed in Yuan (¥). In our main scenario, the model included 1000 patients and when 300 patients previously treated with third-generation chemotherapies were switched to pemetrexed, the total increase in cost, including adverse events and drug cost, to the hospital pharmacy was approximately ¥13.9m. However, the contribution of branded pemetrexed (Alimta) was only 30.3% of the total increase in the budget of the combined cost of branded and generic pemetrexed. When the drug cost was considered, excluding adverse events, the results demonstrated only a slight change. Based on this analysis, the inclusion of branded pemetrexed (Alimta) in the formulary appears manageable compared with generic pemetrexed. A flexible and dynamic approach within the model layout ensured that it is easily adaptable to specific local requirements.